MEDICARE: DR. CHING CHANG D.D.S.

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	1223G0001X	General Practice Dentistry	16112	TX

General Provider Information

NPI Number	:	1497945562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHING CHANG D.D.S.

Provider Business Mailing Address
First Line	:	7710 SHADYVILLA LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-5010
Country	:	US
Telephone Number	:	713-957-0332
Fax Number	:	713-365-9781

Provider Business Practice Location Address
First Line	:	8800 KATY FWY
Second Line	:	SUITE 280
City	:	HOUSTON
State	:	TX
Zip	:	77024-1633
Country	:	US
Telephone Number	:	713-365-9904
Fax Number	:	713-365-9781

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

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	07/25/2007

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Directions to “ DR. CHING CHANG D.D.S.” Practice Location

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