Provider Demographics
NPI:1841556966
Name:CHANG, ELAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 DRYDEN RD
Mailing Address - Street 2:# 5.75
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2400
Mailing Address - Country:US
Mailing Address - Phone:713-798-0150
Mailing Address - Fax:
Practice Address - Street 1:1709 DRYDEN RD
Practice Address - Street 2:# 5.75
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2400
Practice Address - Country:US
Practice Address - Phone:713-798-0150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10043079207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine