MEDICARE: TIFFANY ROSE CHANG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	P7620	TX
2	2084A2900X	Neurocritical Care Physician	P7620	TX

General Provider Information

NPI Number	:	1003098310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY ROSE CHANG M.D.

Provider Business Mailing Address
First Line	:	6400 FANNIN ST STE 2070
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1521
Country	:	US
Telephone Number	:	713-486-8000
Fax Number	:	713-395-8115

Provider Business Practice Location Address
First Line	:	6400 FANNIN ST STE 2800
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030
Country	:	US
Telephone Number	:	713-486-8000
Fax Number	:	713-486-8088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	01/30/2020

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Directions to “ TIFFANY ROSE CHANG M.D.” Practice Location

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