Provider Demographics
NPI:1306802814
Name:CHANG, CRAIG GE-SHENG (MD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:GE-SHENG
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6502 NURSERY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1178
Mailing Address - Country:US
Mailing Address - Phone:361-570-8585
Mailing Address - Fax:361-570-8586
Practice Address - Street 1:6502 NURSERY DR
Practice Address - Street 2:SUITE 300
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1178
Practice Address - Country:US
Practice Address - Phone:361-570-8585
Practice Address - Fax:361-570-8586
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-24
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ7449208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF94045Medicare UPIN
TX8B2859Medicare ID - Type Unspecified