Individual
CHELSEA CHACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8160 WALNUT HILL LN STE 320, DALLAS, TX 75231-4391
(214) 307-7799
Mailing address
2828 LEMMON AVE APT 4120, DALLAS, TX 75204-3802
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA19798
TX
363A00000X
Physician Assistant
PA9116913
FL
363A00000X
Physician Assistant
Primary
PA9118144
FL
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116896100
—
FL
05
—
120895000
—
FL
Enumeration date
06/24/2022
Last updated
07/22/2026
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