Provider Demographics
NPI:1912084567
Name:CHANG, CHRISTINA R (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:R
Last Name:CHANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:3608 PRESTON RD
Mailing Address - Street 2:SUITE 148
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8655
Mailing Address - Country:US
Mailing Address - Phone:972-596-2896
Mailing Address - Fax:972-596-2895
Practice Address - Street 1:3608 PRESTON RD
Practice Address - Street 2:SUITE 148
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8655
Practice Address - Country:US
Practice Address - Phone:972-596-2896
Practice Address - Fax:972-596-2895
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX5063TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist