Organization Active NPI

Leena Chacko M.D P.a

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1609002138
Registry record updated Apr 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LEENA CHACKO M.D P.A
Practice address
17320 Red Oak Dr Ste 260
Houston, TX 77090-2643
Phone
(936) 242-1728
Fax
(936) 447-9145
NPI assigned
Jun 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2020

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

Authorized official

Name
Leena Chacko, M.DNPI 1346208279
Title
President
Phone
(936) 242-1728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

17320 Red Oak Dr Ste 260
Houston, TX 77090-2643

Mailing address

PO Box 131083
The Woodlands, TX 77393-1083
Phone (832) 585-7967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090908000676 TX Part B Supplier - Clinic/Group Practice 8123173580 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX; Shenandoah, TX

National Provider Directory

National Provider Directory

Locations

17320 Red Oak Dr
Ste 260
Houston, TX 77090
Phone (832) 295-9829

129 Vision Park Blvd
Ste 105
Shenandoah, TX 77384
Phone (281) 671-4455

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587772800000",
    "number": "1609002138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131083",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773931083",
            "telephone_number": "832-585-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17320 RED OAK DR STE 260",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770902643",
            "telephone_number": "936-242-1728",
            "fax_number": "936-447-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEENA CHACKO M.D P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-10",
        "last_updated": "2020-04-25",
        "certification_date": "2020-04-25",
        "status": "A",
        "authorized_official_last_name": "CHACKO",
        "authorized_official_first_name": "LEENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-242-1728",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.