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General NPI Number Information
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NPI Number | 1720317290
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Entity Type | Organization
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Legal Business Name | CAROL C CHANG, DDS, PA
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Dates
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Enumeration Date | 12/12/2009
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 17125 WESTHEIMER RD
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City | HOUSTON
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State | TX
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Zip | 77082-1259
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Country | US
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Telephone | 281-277-3405
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Fax |
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Provider Business Mailing Address
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Address Line | 17125 WESTHEIMER RD
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City | HOUSTON
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State | TX
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Zip | 77082-1259
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Country | US
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Telephone | 281-277-3405
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROL C CHANG
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Credential | DDS
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Telephone | 281-277-3405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 20110
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License Number State | TX
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