Provider Demographics
NPI:1184075657
Name:CHENTNIK, KIMBLE ELISABETH (OD)
Entity type:Individual
Prefix:
First Name:KIMBLE
Middle Name:ELISABETH
Last Name:CHENTNIK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KIMBLE
Other - Middle Name:
Other - Last Name:SLONAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:6699 CHIMNEY ROCK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-5339
Mailing Address - Country:US
Mailing Address - Phone:713-661-6500
Mailing Address - Fax:713-661-6527
Practice Address - Street 1:6699 CHIMNEY ROCK
Practice Address - Street 2:SUITE 201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081
Practice Address - Country:US
Practice Address - Phone:713-661-6500
Practice Address - Fax:713-661-6527
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9001152W00000X
TX9001-TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist