Individual
KEVIN K CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4649 SEABISCUIT ST, CARROLLTON, TX 75010-4206
(214) 938-6605
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
BP10064499
TX
208000000X
Pediatrics Physician
Primary
T2840
TX
Other
Enumeration date
05/15/2018
Last updated
09/28/2021
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