1962463679 NPI number — CLAIRE H CHANG MD PA

Table of content: (NPI 1962463679)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962463679 NPI number — CLAIRE H CHANG MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLAIRE H CHANG MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962463679
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6678
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77265
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-988-8595
Provider Business Mailing Address Fax Number:
713-988-3244

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 BINZ
Provider Second Line Business Practice Location Address:
STE 1220
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-988-8595
Provider Business Practice Location Address Fax Number:
713-988-3244
Provider Enumeration Date:
03/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHANG
Authorized Official First Name:
CLAIRE
Authorized Official Middle Name:
H
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
713-988-8595

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0069GX . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: DD3155 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P00220702 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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