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1710573159
SUSAN CHACKO
DALLAS, TX
NPI
1710573159
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: TX AP140734)
Enumeration Date
2020-12-20
Last Update Date
2020-12-20
Business Address
SUSAN CHACKO APRN
5200 HARRY HINES BLVD
DALLAS, TX 75235-7709
Phone number: 516-941-7930
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Mailing Address
SUSAN CHACKO APRN
1024 BLUE HERON DR
FORNEY, TX 75126-8311
Phone number: 516-941-7930
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