Provider Demographics
NPI:1588366728
Name:SMITH, CHUNDRA RENEE
Entity type:Individual
Prefix:
First Name:CHUNDRA
Middle Name:RENEE
Last Name:SMITH
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 1:7426 LANGLEY RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016-2730
Mailing Address - Country:US
Mailing Address - Phone:713-296-9419
Mailing Address - Fax:
Practice Address - Street 1:7426 LANGLEY RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016-2730
Practice Address - Country:US
Practice Address - Phone:713-296-9419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator