Provider Demographics
NPI:1063855922
Name:GITTENS, MONIQUE ROCHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:ROCHELLE
Last Name:GITTENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11240 FM 1960 RD W STE 210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3665
Mailing Address - Country:US
Mailing Address - Phone:281-469-7400
Mailing Address - Fax:
Practice Address - Street 1:11240 FM 1960 RD W STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3665
Practice Address - Country:US
Practice Address - Phone:281-469-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT8823208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program