Provider Demographics
NPI:1336031582
Name:KITCHEN, BOBBY RAY
Entity type:Individual
Prefix:
First Name:BOBBY
Middle Name:RAY
Last Name:KITCHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BOBBY
Other - Middle Name:RAY
Other - Last Name:KITCHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8103 WOODWARD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-1325
Mailing Address - Country:US
Mailing Address - Phone:281-387-1952
Mailing Address - Fax:
Practice Address - Street 1:8103 WOODWARD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051-1325
Practice Address - Country:US
Practice Address - Phone:281-387-1952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70472101YA0400X
TX2083-1124175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)