Provider Demographics
NPI:1083877740
Name:CHANG, EMMANUEL YIH-HERNG (MD/PHD)
Entity type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:YIH-HERNG
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 WEST LOOP S STE 400
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3510
Mailing Address - Country:US
Mailing Address - Phone:713-799-9975
Mailing Address - Fax:713-799-1095
Practice Address - Street 1:6565 WEST LOOP S STE 400
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3510
Practice Address - Country:US
Practice Address - Phone:713-799-9975
Practice Address - Fax:713-799-1095
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5786207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1083877740Medicaid
1083877740OtherNPI
TX322767002Medicaid
TX322767003Medicaid
TX322767004Medicaid
TX322767005Medicaid
TX322767005Medicaid
TX322767003Medicaid
1083877740OtherNPI
TX295184YNTHMedicare PIN
MI0Q26082052Medicare PIN