Provider Demographics
NPI:1306919162
Name:KIENTCHA -TITA, RACHEL CHUNDENU (MD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:CHUNDENU
Last Name:KIENTCHA -TITA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:RACHEL
Other - Middle Name:CHUNDENU
Other - Last Name:TITA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2424 HAMILTON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-1203
Mailing Address - Country:US
Mailing Address - Phone:713-485-4005
Mailing Address - Fax:
Practice Address - Street 1:2424 HAMILTON ST STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-1203
Practice Address - Country:US
Practice Address - Phone:281-933-4447
Practice Address - Fax:281-933-5557
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0003310207Q00000X
TXM9410207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207Q00000XOtherFAMILY MEDICINE TAXONOMY CODE
TX207Q00000XOtherFAMILY MEDICINE TAXONOMY CODE
TXM9410OtherTEXAS LICENCE
TXM9410OtherTEXAS LICENCE
TX8F8111Medicare PIN