Provider Demographics
NPI:1003093410
Name:CHAKAKI, ALIA (DDS,MSD)
Entity Type:Individual
Prefix:DR
First Name:ALIA
Middle Name:
Last Name:CHAKAKI
Suffix:
Gender:F
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 SW MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1535
Mailing Address - Country:US
Mailing Address - Phone:210-928-2814
Mailing Address - Fax:210-579-6898
Practice Address - Street 1:11550 LOUETTA RD
Practice Address - Street 2:SUITE #400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1368
Practice Address - Country:US
Practice Address - Phone:281-320-0400
Practice Address - Fax:281-320-9764
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX232261223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics