Provider Demographics
NPI:1881025294
Name:CHAN, KAI-CHANG
Entity Type:Individual
Prefix:
First Name:KAI-CHANG
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9240 GUILBEAU RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-3091
Mailing Address - Country:US
Mailing Address - Phone:210-509-8282
Mailing Address - Fax:
Practice Address - Street 1:11637 BANDERA RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-6851
Practice Address - Country:US
Practice Address - Phone:210-419-8777
Practice Address - Fax:210-319-7071
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01482171100000X
TX1360285225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist