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General NPI Number Information
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NPI Number | 1023353570
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Entity Type | Organization
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Legal Business Name | DR. PETER CHANG
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 6565 W. LOOP S #300
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City | BELLAIRE
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State | TX
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Zip | 77401
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Country | US
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Telephone | 713-479-1100
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Fax | 713-629-6032
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Provider Business Mailing Address
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Address Line | 6565 W. LOOP S #300
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City | BELLAIRE
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State | TX
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Zip | 77401
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Country | US
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Telephone | 713-479-1100
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Fax | 713-629-6032
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER CHANG
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Credential | MDPHD
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Telephone | 713-479-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | F9292
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License Number State | TX
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