Provider Demographics
NPI:1891790606
Name:CHACKO, SHIRLEY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:
Last Name:CHACKO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 BOONE RD
Mailing Address - Street 2:EL FRANCO LEE HEALTH CENTER PHARMACY
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099
Mailing Address - Country:US
Mailing Address - Phone:281-454-0781
Mailing Address - Fax:281-454-0780
Practice Address - Street 1:8901 BOONE RD
Practice Address - Street 2:EL FRANCO LEE HEALTH CENTER PHARMACY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099
Practice Address - Country:US
Practice Address - Phone:281-454-0781
Practice Address - Fax:281-454-0780
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist