DR. ANJU MATHEW CHACKO M.D, NPI 1316120900 — SUGAR LAND (TX)

NPI 1316120900

12+ Years Experience Individual

DR. ANJU MATHEW CHACKO M.D

12.06.2007
PROVIDER ENUMERATION DATE
04.08.2016
LAST UPDATE DATE
1316120900
NPI NUMBER

About DR. ANJU MATHEW CHACKO

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

DR. ANJU MATHEW CHACKO is a provider established in SUGAR LAND, TX. The NPI number of DR. ANJU MATHEW CHACKO is 1316120900 and was assigned on 12.06.2007. The practitioners primary taxonomy code is: 207Q00000X with license number: MT190718 PA .

Mailing address

  • City: HOUSTON
  • State: TX
  • Postal code: 770242301
  • Phone: 7133384523
  • Address: 909 FROSTWOOD DR
  • Address 2: SUITE 1.100

Primary Practice Address

  • Region : SUGAR LAND, TX
  • NPI : 1316120900
  • Phone : 2812658125
  • Fax : 8326585430
  • Postalcode : 774794629
  • Address : 1227 MUSEUM SQUARE DR SUITE A

Provider taxonomy - Family Medicine

  • Taxonomy code: 207Q00000X
  • License number: MT190718
  • License state: PA

The taxonomy is not the primary taxonomy.

Taxonomy description: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Healthcare provider taxonomy #2 - Family Medicine

  • Taxonomy code: 207Q00000X
  • License number: P0710
  • License state: TX

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Contacts:

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  • DR. ANJU MATHEW CHACKO M.D
  • Address : 1227 MUSEUM SQUARE DR SUITE A
  • Region : SUGAR LAND, TX
  • NPI : 1316120900
  • Phone : 2812658125
  • Fax : 8326585430
  • Postalcode : 774794629

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address1227 MUSEUM SQUARE DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE A
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameSUGAR LAND
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTX
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code774794629
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2812658125
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number8326585430
The fax number associated with the location address of the provider being identified.
NPI1316120900
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207Q00000X
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Provider Enumeration Date12.06.2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated04.08.2016
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. ANJU MATHEW CHACKO
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address909 FROSTWOOD DR
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 1.100
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameHOUSTON
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTX
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code770242301
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number7133384523
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1207Q00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Provider License Number 1MT190718
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1PA
Healthcare Provider Primary Taxonomy Switch 1N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2207Q00000X
Healthcare Provider Taxonomy 2Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Provider License Number 2P0710
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2TX
Healthcare Provider Primary Taxonomy Switch 2Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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