Provider Demographics
NPI:1861233736
Name:OFFETT, KYRAH JIRRECCE' (PHARMD)
Entity type:Individual
Prefix:
First Name:KYRAH
Middle Name:JIRRECCE'
Last Name:OFFETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 HIDALGO ST APT 121
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6451
Mailing Address - Country:US
Mailing Address - Phone:832-312-1783
Mailing Address - Fax:
Practice Address - Street 1:12850 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4972
Practice Address - Country:US
Practice Address - Phone:713-365-6704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist