Provider Demographics
NPI:1902151715
Name:REDMAN, DARREN (DDS)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:REDMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRIAR HOLLOW LN STE 140
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-2820
Mailing Address - Country:US
Mailing Address - Phone:713-621-7616
Mailing Address - Fax:
Practice Address - Street 1:19 BRIAR HOLLOW LN STE 140
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-2820
Practice Address - Country:US
Practice Address - Phone:713-621-7616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX280121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice