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Individual

THRESIAMMA K CHACKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
205 E TORONTO AVE, MCALLEN, TX 78503-1209
(956) 296-3990
(956) 665-6836
Mailing address
PO BOX 531968, HARLINGEN, TX 78553-1968
(833) 887-4863
(956) 296-6842

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP131168
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
754320
REGISTERED NURSE
01
AP131168
MEDICAL LIC.
TX
Enumeration date
06/13/2017
Last updated
10/07/2024
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