Provider Demographics
NPI:1518031335
Name:CHIANG, CHRISTINE SHIE (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:SHIE
Last Name:CHIANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 TIMBER CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-9225
Mailing Address - Country:US
Mailing Address - Phone:972-713-7151
Mailing Address - Fax:
Practice Address - Street 1:1701 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4520
Practice Address - Country:US
Practice Address - Phone:972-713-7151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6130T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist