Individual
MR. BIJU K CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
800 W CAMPBELL RD, RICHARDSON, TX 75080-3021
(972) 883-2749
(972) 883-2069
Mailing address
1000 LAKE CAROLYN PKWY, #2101, IRVING, TX 75039-3932
(469) 879-4761
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04258
TX
Other
Enumeration date
10/12/2005
Last updated
11/29/2018
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