Healthcare Provider Details

I. General information

NPI: 1992995708
Provider Name (Legal Business Name): SFHD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 MEDICAL PARK SUITE A
HUNTSVILLE TX
77340-4971
US

IV. Provider business mailing address

812 ELKINS LK
HUNTSVILLE TX
77340-7322
US

V. Phone/Fax

Practice location:
  • Phone: 936-435-0014
  • Fax: 936-435-9108
Mailing address:
  • Phone: 936-291-0988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK3891
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK3891
License Number StateTX

VIII. Authorized Official

Name: DR. SHAO-JEN CHANG
Title or Position: DIRECTOR
Credential: M.D.
Phone: 936-291-0988