Individual
MR. PHILIP CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, CNS
Contact information
Practice address
1201 W 38TH ST, AUSTIN, TX 78705-1006
(512) 324-1864
(512) 419-9016
Mailing address
4515 SETON CENTER PKWY STE 215, AUSTIN, TX 78759-5785
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
AP128753
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
354374601
MEDICAID SAIMS ROT
TX
01
—
354374602
MEDICAID SAIMS TRAVIS
TX
01
—
466748YLP1
MEDICARE SAIMS TRAVIS
TX
01
—
466748YLP2
MEDICARE SAIMS ROT
TX
Enumeration date
08/10/2015
Last updated
02/20/2017
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