Chacko, Mariam
Chacko, Mariam is an individual health care provider with primary practice located at 6701 Fannin St , Houston TX 77030-2316. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Chacko, Mariam can be contacted via phone (832) 822-2778.Contact Information
Primary practice address
6701 Fannin St
Houston TX 77030-2316
Phone: (832) 822-2778
Fax: (832) 825-3141
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | G6915 | Texas |
Profile Details
| NPI number | 1750461182 |
|---|---|
| LBN Legal business name | Chacko, Mariam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2006 |
| Last updated | Jul 25th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750461182 | NPPES |
| Texas | MEDICAID | 136190901 |
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