Individual
REEBA E CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1502 TAUB LOOP, HOUSTON, TX 77030-1608
(713) 970-7000
Mailing address
17207 KUYKENDAHL RD, SUITE 100, SPRING, TX 77379-8423
(281) 374-8555
(281) 374-8335
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J1250
TX
2084P0804X
Child & Adolescent Psychiatry Physician
J1250
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166156301
—
TX
05
—
166156302
—
TX
05
—
166156303
—
TX
01
—
8K0021
BC/BS NUMBER
TX
Enumeration date
04/21/2006
Last updated
02/17/2020
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