Provider Demographics
NPI:1811385438
Name:CHANG, EILEEN (FNP-C)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:
Other - Last Name:MELGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5115 AVENUE H STE 701
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2477
Mailing Address - Country:US
Mailing Address - Phone:713-486-1950
Mailing Address - Fax:
Practice Address - Street 1:5115 AVENUE H STE 701
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2477
Practice Address - Country:US
Practice Address - Phone:713-486-1950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126520363LF0000X
WAAP60755723363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily