Provider Demographics
NPI:1568423200
Name:CHANG, CLAIRE H (MD PA)
Entity Type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:H
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4346
Mailing Address - Street 2:DEPT 521
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:713-580-2500
Mailing Address - Fax:713-580-2597
Practice Address - Street 1:5115 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9749
Practice Address - Country:US
Practice Address - Phone:713-580-2500
Practice Address - Fax:713-580-2597
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0072207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0069GXOtherBLUE CROSS BLUE SHIELD
TX144535503Medicaid
TX144535504Medicaid
TX174671101Medicaid
TX180042438OtherRAILROAD MEDICARE
TXP00220702OtherRAILROAD MEDICARE
TXDD3155OtherRAILROAD MEDICARE
TX0069GXOtherBLUE CROSS BLUE SHIELD
TXP00220702OtherRAILROAD MEDICARE
8D4280Medicare ID - Type Unspecified
H19947Medicare UPIN
TX00234QMedicare ID - Type Unspecified