Provider Demographics
NPI:1578637393
Name:CHIANG, DAVID SHIE (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SHIE
Last Name:CHIANG
Suffix:
Gender:M
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:817-749-4479
Mailing Address - Fax:
Practice Address - Street 1:2601 E NORTHWEST PKWY
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6668
Practice Address - Country:US
Practice Address - Phone:817-749-4479
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
TX6131T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist