Active NPI
Jacob Pulprayil Chacko
- Massage Therapist
- Stafford, TX
National Provider Identifier
1144007626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT137796
- Practice address
- 506 Colony Lake Estates Dr
Stafford, TX 77477-4596 - Phone
- (832) 228-5338
- NPI assigned
- Sep 11, 2023
- Last updated
- Sep 11, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT137796 | TX | Primary |
Addresses
Primary practice location
506 Colony Lake Estates Dr
Stafford, TX 77477-4596
Mailing address
506 Colony Lake Estates Dr
Stafford, TX 77477-4596
Phone (832) 228-5338
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT137796 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1144007626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 COLONY LAKE ESTATES DR",
"city": "STAFFORD",
"state": "TX",
"postal_code": "774774596",
"telephone_number": "832-228-5338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 COLONY LAKE ESTATES DR",
"city": "STAFFORD",
"state": "TX",
"postal_code": "774774596",
"telephone_number": "832-228-5338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACKO",
"first_name": "JACOB",
"middle_name": "PULPRAYIL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-11",
"last_updated": "2023-09-11",
"certification_date": "2023-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT137796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stafford, TX
- Eredio Celestino III, PT, DPT
- Center for Advanced Infusion (Urea Dialysis Inc)
- Center for Work Based Initiatives, LLC
- Centers for Mobility Rosenberg LP
- CH Stafford LLC (Clinica Universo Latino)
- Rhonney E Chacko, OPTICIAN
- Christina L Chambers
- Crystal Latrice Champion-Kendricks, PHARM D
- Yu-Chen Chang
- Change Academy at Lake of the Ozarks
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.