MEDICARE: VANESSA LOO CHANG & DENNIS M CHANG OD PTR

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	152W00000X	Optometrist		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770787392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANESSA LOO CHANG & DENNIS M CHANG OD PTR

Provider Business Mailing Address
First Line	:	318 W NOLANA AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-2528
Country	:	US
Telephone Number	:	956-664-0444
Fax Number	:	956-664-0446

Provider Business Practice Location Address
First Line	:	318 W NOLANA
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-2528
Country	:	US
Telephone Number	:	956-664-0444
Fax Number	:	956-664-0446

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. VANESSA L CHANG
Credential	:	OD
Telephone Number	:	956-664-0444

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	05/16/2012

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