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NPI Code Detail

MEDICARE: REEBA E CHACKO M.D.

MEDICARE: REEBA E CHACKO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry PhysicianJ1250TX
22084P0800XPsychiatry PhysicianJ1250TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28K0021OTHERTXBC/BS NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881650786
Entity Type Code : Individual
Provider Name (Legal Business Name) : REEBA E CHACKO M.D.
Provider Business Mailing Address
First Line : 17207 KUYKENDAHL RD
Second Line : SUITE 100
City : SPRING
State : TX
Zip : 77379-8423
Country : US
Telephone Number : 281-374-8555
Fax Number : 281-374-8335
Provider Business Practice Location Address
First Line : 1502 TAUB LOOP
Second Line :
City : HOUSTON
State : TX
Zip : 77030-1608
Country : US
Telephone Number : 713-970-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2006
Last Update Date : 02/17/2020

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Directions to “ REEBA E CHACKO M.D.” Practice Location

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