Provider Demographics
NPI:1316471204
Name:CHANG, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BROOKLYN AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4828
Mailing Address - Country:US
Mailing Address - Phone:210-229-1048
Mailing Address - Fax:210-615-0888
Practice Address - Street 1:4499 MEDICAL DR STE 289
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3712
Practice Address - Country:US
Practice Address - Phone:210-614-3264
Practice Address - Fax:210-615-0888
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXUA47592080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program