Healthcare Provider Details

I. General information

NPI: 1689683153
Provider Name (Legal Business Name): EDUARDO ENRIQUE CHANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EDUARDO ENRIQUE CHANG M.D.

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3115 COLLEGE PARK DR STE 110
THE WOODLANDS TX
77384-4001
US

IV. Provider business mailing address

3115 COLLEGE PARK DR STE. 110
THE WOODLANDS TX
77384-4000
US

V. Phone/Fax

Practice location:
  • Phone: 936-447-9352
  • Fax: 936-447-9354
Mailing address:
  • Phone: 936-447-9352
  • Fax: 936-447-9354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number01081155A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA67939
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberA67939
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberL0073
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA67939
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD.022572
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: