Provider Demographics
NPI:1265229249
Name:STARRAK, CHAD MATTHEW
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:MATTHEW
Last Name:STARRAK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 EAGLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2051
Mailing Address - Country:US
Mailing Address - Phone:361-648-0476
Mailing Address - Fax:
Practice Address - Street 1:31 EAGLE CREEK DR
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2051
Practice Address - Country:US
Practice Address - Phone:361-648-0476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106445101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health