Physician Compare National (NPI:1316058266)

HEALTHCARE PROVIDER: PHYLLIS CLARA CHANG M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1316058266
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385839349
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101116000715
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHANG
	Individual professional last name
Provider First Name	PHYLLIS
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CENTRAL TEXAS DIGESTIVE DISEASE ASSOCIATION, PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4284618711
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	9
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1602 W ROCK PRAIRE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	COLLEGE STATION
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	77845
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9797764600
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHI ST JOSEPH HEALTH
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y