Individual
PETER TAE-JIN CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1977 BUTLER BLVD, HOUSTON, TX 77030-4101
(713) 798-6100
(713) 798-4082
Mailing address
PO BOX 4771, HOUSTON, TX 77210-4771
(713) 798-6100
(713) 798-4082
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L8645
TX
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
L8645
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1038135
BLUE LINK
TX
05
—
165744701
—
TX
05
—
165744702
—
TX
01
—
8G7723
BC/BS
TX
Enumeration date
10/20/2005
Last updated
07/21/2022
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