Individual provider · Type 1 NPI
Mathew Vadakkeveettil Chacko, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Dallas, TX
NPI number
1104538552
Active
Practice location
4500 S Lancaster Rd
Dallas, TX 75216-7167
Mailing address
306 Sunset Ct
Sunnyvale, TX 75182-1003
Other practice locations
- 2306 Guthrie Rd Ste 260H, Garland, TX 75043-5967 · (972) 424-4401
- 202 S 2nd St, Laramie, WY 82070-3602 · (323) 205-7088
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 57478 (WY) |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 739088 (TX) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 1089361 (TX) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1104538552
Mathew Vadakkeveettil Chacko, PMHNP-BC's National Provider Identifier is 1104538552, issued on Dec 16, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Dallas, TX. The record was last updated on Dec 2, 2025.