Provider Demographics
NPI:1528646924
Name:REDMOND, BRANDI LYNN
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:LYNN
Last Name:REDMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 FOUNTAIN VIEW DR # 1030
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-3206
Mailing Address - Country:US
Mailing Address - Phone:281-877-2963
Mailing Address - Fax:
Practice Address - Street 1:1940 FOUNTAIN VIEW DR # 1030
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3206
Practice Address - Country:US
Practice Address - Phone:281-877-2963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)