Individual
BENJAMIN CHACKO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3851 ROGER BROOKE DR, BROOKE ARMY MEDICAL CENTER. MCHE-QD/ CREDENTIALS, FORT SAM HOUSTON, TX 78234-4501
(210) 916-1245
Mailing address
11 MYRTLEWOOD, SAN ANTONIO, TX 78218-6000
(210) 822-3087
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA04730600
NJ
Other
Enumeration date
10/27/2005
Last updated
07/08/2007
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