Individual provider Active NPI

Cheryl Chacko Thamaravelil, M. D.

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1245461177
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P4033 Issued in TX
Practice address
3639 Holmes St
Dallas, TX 75215-3605
Phone
(972) 354-8712
Fax
(972) 354-8728
NPI assigned
Jul 27, 2009
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43613 KY
Family Medicine Physician 207Q00000X P4033 TX Primary
Obstetrics Physician 207VX0000X P4033 TX

Addresses

Primary practice location

3639 Holmes St
Dallas, TX 75215-3605

Mailing address

3639 Holmes St
Dallas, TX 75215-3605
Phone (972) 354-8712

Other identifiers 1

IdentifierTypeStateIssuer
P4033OtherTXLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130522000575 TX Practitioner - Family Practice 9133367642 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43613KYMDFamily Medicine Physician
P4033TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Ministries Inc. CurrentSince Mar 11, 2025 Accepting new patients
Valora Medical Center LLC CurrentSince Aug 4, 2021 Accepting new patients
Healing Hands Ministries Inc. Past Accepting new patients
Healing Hands Ministries Inc. PastSince Mar 11, 2025 Accepting new patients

Locations

3639 Holmes St
Dallas, TX 75215
Phone 21422108552034

1004 S Carrier Pkwy
Grand Prairie, TX 75051
Phone (214) 677-1300

5601 Executive Dr
Ste 200
Irving, TX 75038
Phone (352) 565-7290

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1245461177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 HOLMES ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752153605",
            "telephone_number": "972-354-8712",
            "fax_number": "972-354-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 HOLMES ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752153605",
            "telephone_number": "972-354-8712",
            "fax_number": "972-354-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAMARAVELIL",
        "first_name": "CHERYL",
        "middle_name": "CHACKO",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "43613",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P4033",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "TX",
            "license": "P4033",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "P4033",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.