Provider Demographics
NPI:1295727956
Name:CHAKMAKJIAN, ZAVEN H (MD)
Entity type:Individual
Prefix:
First Name:ZAVEN
Middle Name:H
Last Name:CHAKMAKJIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 N CENTRAL EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-5735
Mailing Address - Country:US
Mailing Address - Phone:214-823-6435
Mailing Address - Fax:214-823-4675
Practice Address - Street 1:910 N CENTRAL EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-5735
Practice Address - Country:US
Practice Address - Phone:214-823-6435
Practice Address - Fax:214-823-4675
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD5533174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033981401Medicaid
TN0609656OtherAETNA
TX112039337OtherRAILROAD MEDICARE
TX2818648002OtherCIGNA
TX15313866OtherPACIFICARE
TX595243OtherUNITED
TX15313866OtherPACIFICARE
TXB21767Medicare UPIN