Individual
CHARLES S CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4001 W 15TH ST, SUITE 260, PLANO, TX 75093-5841
(214) 778-2530
(214) 778-2542
Mailing address
PO BOX 262449, PLANO, TX 75026-2449
(214) 778-2530
(214) 778-2542
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
11048
NH
207T00000X
Neurological Surgery Physician
206001
MA
207T00000X
Neurological Surgery Physician
Primary
H3003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023240751
GROUP NPI
TX
05
—
130364608
—
TX
01
—
8CC790
BLUE CROSS PROVIDER NUMBER
TX
01
—
H3003
TX LICENSE #
TX
Enumeration date
08/26/2005
Last updated
01/23/2012
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