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General NPI Number Information
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NPI Number | 1902282221
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Entity Type | Individual
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Provider Name | PHILIP CHANG RN, CNS
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Gender | Male
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 1201 W 38TH ST
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City | AUSTIN
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State | TX
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Zip | 78705-1006
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Country | US
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Telephone | 512-324-1864
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Fax | 512-419-9016
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Provider Business Mailing Address
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Address Line | 4515 SETON CENTER PKWY STE 215
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City | AUSTIN
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State | TX
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Zip | 78759-5785
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Country | US
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Telephone |
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Fax |
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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 | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | AP128753
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License Number State | TX
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