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General NPI Number Information
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NPI Number | 1003813619
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Entity Type | Individual
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Provider Name | JUNE-CHIEH CHANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2005
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 100 MEDICAL CENTER BLVD STE 102
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City | CONROE
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State | TX
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Zip | 77304-2821
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Country | US
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Telephone | 936-756-9522
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Fax | 936-756-9523
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Provider Business Mailing Address
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Address Line | 100 MEDICAL CENTER BLVD STE 102
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City | CONROE
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State | TX
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Zip | 77304-2821
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Country | US
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Telephone | 936-756-9522
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Fax | 936-756-9523
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K4020
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K4020
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | K4020
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License Number State | TX
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