Provider Demographics
NPI:1083877740
Name:CHANG, EMMANUEL YIH-HERNG (MD/PHD)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:YIH-HERNG
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 GRAMERCY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1617
Mailing Address - Country:US
Mailing Address - Phone:713-799-9975
Mailing Address - Fax:713-799-1095
Practice Address - Street 1:2727 GRAMERCY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1617
Practice Address - Country:US
Practice Address - Phone:713-799-9975
Practice Address - Fax:713-799-1095
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5786207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX322767004Medicaid
TX322767002Medicaid
MI1083877740Medicaid
TX322767003Medicaid
TX322767005Medicaid
1083877740OtherNPI
TX322767005Medicaid
TX322767003Medicaid
1083877740OtherNPI
TX295184YNTHMedicare PIN
MI0Q26082052Medicare PIN