Provider Demographics
NPI:1982142543
Name:CHANKO, KARA
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:CHANKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 410
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7313
Mailing Address - Country:US
Mailing Address - Phone:713-255-5097
Mailing Address - Fax:713-626-2337
Practice Address - Street 1:4141 SOUTHWEST FWY
Practice Address - Street 2:SUITE 410
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7313
Practice Address - Country:US
Practice Address - Phone:713-255-5097
Practice Address - Fax:713-626-2337
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
5282246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic