Individual
RONY THANNIMOOTTILCHIRAYIL CHACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1001 RAINTREE CIR, ALLEN, TX 75013-4912
(972) 908-2000
Mailing address
4025 BASHFUL DR, PLANO, TX 75093-6977
(469) 866-2643
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1141167
TX
363LA2200X
Adult Health Nurse Practitioner
1141167
TX
363LG0600X
Gerontology Nurse Practitioner
1141167
TX
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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