Provider Demographics
NPI:1295007599
Name:DR CHRISTINA R CHANG & ASSOCIATES, OD, PA
Entity Type:Organization
Organization Name:DR CHRISTINA R CHANG & ASSOCIATES, OD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-596-2896
Mailing Address - Street 1:3608 PRESTON RD
Mailing Address - Street 2:SUITE 148
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8655
Mailing Address - Country:US
Mailing Address - Phone:972-596-2896
Mailing Address - Fax:
Practice Address - Street 1:3608 PRESTON RD
Practice Address - Street 2:SUITE 148
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8655
Practice Address - Country:US
Practice Address - Phone:972-596-2896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5063TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty