Provider Demographics
NPI:1982803433
Name:BILL K CHANG MD PA
Entity Type:Organization
Organization Name:BILL K CHANG MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-855-5505
Mailing Address - Street 1:PO BOX 58687
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8687
Mailing Address - Country:US
Mailing Address - Phone:281-554-8919
Mailing Address - Fax:281-554-6045
Practice Address - Street 1:560 BLOSSOM ST
Practice Address - Street 2:SUITE A
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4236
Practice Address - Country:US
Practice Address - Phone:281-554-8919
Practice Address - Fax:281-554-6045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-15
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0040XPOtherBCBSTX
TXDG9013OtherRRMEDICARE
TX191236201Medicaid
TXDG9013OtherRRMEDICARE