Provider Demographics
NPI:1104971043
Name:CHANG, DARLYNN CHAICHA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DARLYNN
Middle Name:CHAICHA
Last Name:CHANG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:DARLYNN
Other - Middle Name:
Other - Last Name:CHAICHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1000 E 51ST ST STE 925
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-2232
Mailing Address - Country:US
Mailing Address - Phone:512-978-9940
Mailing Address - Fax:512-901-9703
Practice Address - Street 1:1000 E 51ST ST STE 925
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-2232
Practice Address - Country:US
Practice Address - Phone:512-978-9940
Practice Address - Fax:512-901-9703
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04336363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant