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General NPI Number Information
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NPI Number | 1477515864
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Entity Type | Individual
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Provider Name | CHANGIL LEE BACHMAN FNP
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Gender | Male
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 1295 ARRINGTON RD STE 300
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City | COLLEGE STATION
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State | TX
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Zip | 77845-8603
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Country | US
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Telephone | 979-213-5218
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Fax | 979-213-5219
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Provider Business Mailing Address
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Address Line | 5000 ELDORADO PKWY, BOX 150-153
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City | FRISCO
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State | TX
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Zip | 75033
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Country | US
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Telephone | 469-598-1200
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Fax | 972-637-9272
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP113612
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License Number State | TX
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