Mathew Vadakkeveettil Chacko, PMHNP-BC
Nurse Practitioner, Psych/Mental Health in Dallas, TX. Individual provider (NPI-1).
NPI number1104538552
StatusActive
Last updated in NPPESDec 2, 2025
Details
- NPI
- 1104538552
- Entity type
- Individual (NPI-1)
- Name
- Mathew Vadakkeveettil Chacko
- Credential
- PMHNP-BC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 16, 2022
- Certification date
- Dec 2, 2025
- Last updated
- Dec 2, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 1089361 | TX | Yes |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 57478 | WY | |
| 163WP0808X | Registered Nurse, Psych/Mental Health | 739088 | TX |
Other names
- Mathew V Chacko (Former Name)
Practice location
4500 S Lancaster RdDallas, TX 75216-7167
Phone 214-727-1031
Mailing address
306 Sunset CtSunnyvale, TX 75182-1003
Phone 214-727-1031
Other practice locations
2306 Guthrie Rd Ste 260h
Garland, TX 75043-5967
Garland, TX 75043-5967
Phone 972-424-4401
202 S 2nd St
Laramie, WY 82070-3602
Laramie, WY 82070-3602
Phone 323-205-7088
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 376 Psychiatric/Mental Health Nurse Practitioner providers in Dallas · All 47,373 providers in Dallas
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