Mathew Vadakkeveettil Chacko, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1089361 Issued in TX

Practice address

4500 S Lancaster Rd
Dallas, TX 75216-7167

Phone

(214) 727-1031

NPI assigned

Dec 16, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Mathew V Chacko Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Texas Hospice Providers LLC

  • Community Based Hospice Care Agency
  • Garland, TX
  • NPI 1568058675
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1104538552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 SUNSET CT",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751821003",
            "telephone_number": "214-727-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "214-727-1031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2306 Guthrie Rd Ste 260H",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750435967",
            "country_code": "US",
            "telephone_number": "972-424-4401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 S 2nd St",
            "address_purpose": "LOCATION",
            "city": "Laramie",
            "state": "WY",
            "postal_code": "820703602",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "MATHEW",
        "middle_name": "VADAKKEVEETTIL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-16",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WY",
            "license": "57478",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "739088",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1089361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATHEW",
            "last_name": "CHACKO",
            "middle_name": "V",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rana Adnan Chaaban
• Mayerlin Chacin
• Anita Chacko, RNP-C
• Chelsea Chacko
• Manoj Chacko, BS
• Sarah Chacko, RN
• Sibi Chacko
• Susan Chacko, APRN
• Marina Bliss Chacon
• Sophia Louise Chacon

• All providers in Dallas, TX
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.