Provider Demographics
NPI:1356385249
Name:CHANG, WEN-LI
Entity type:Individual
Prefix:
First Name:WEN-LI
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 BELLAIRE BLVD
Mailing Address - Street 2:STE 211
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4527
Mailing Address - Country:US
Mailing Address - Phone:281-520-7037
Mailing Address - Fax:281-265-1556
Practice Address - Street 1:16605 SOUTHWEST FWY
Practice Address - Street 2:STE 350
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3482
Practice Address - Country:US
Practice Address - Phone:281-520-7037
Practice Address - Fax:281-265-1556
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3622207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34449108Medicaid
TXF23280Medicare UPIN
TX611847Medicare ID - Type Unspecified