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General NPI Number Information
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NPI Number | 1912469552
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Entity Type | Individual
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Provider Name | ANN CHACKO DO
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Gender | Female
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Dates
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Enumeration Date | 04/03/2019
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 800 WASHINGTON ST
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City | BOSTON
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State | MA
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Zip | 02111-1552
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Country | US
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Telephone | 617-636-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 301 UNIVERSITY BLVD GALVESTON TX 7755
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City | GALVESTON
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State | TX
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Zip | 77555-0354
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Country | US
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Telephone | 409-747-0534
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Fax | 409-747-0721
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 77085-21
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License Number State | WI
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