Provider Demographics
NPI:1053511139
Name:CHANG, YAN PING (PTA)
Entity Type:Individual
Prefix:
First Name:YAN PING
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3622 VILLAVERDE AVE APT 114
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-8027
Mailing Address - Country:US
Mailing Address - Phone:682-429-4206
Mailing Address - Fax:
Practice Address - Street 1:8502 EDGEMERE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-3523
Practice Address - Country:US
Practice Address - Phone:214-615-7045
Practice Address - Fax:214-695-5598
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities