Provider Demographics
NPI:1427068766
Name:CHANG, ALBERT S (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:S
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7026 OLD KATY RD STE 276
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2187
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7026 OLD KATY RD STE 276
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2187
Practice Address - Country:US
Practice Address - Phone:713-621-7436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1202982085N0700X, 2085R0202X
MS217782085R0202X
NH134842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432732699Medicaid
NH30206885Medicaid
NHAA96675OtherHARVARD PILGRIM HEALTHCAR
FL012387500Medicaid
NH01Y011899NH01OtherANTHEM
NH000093901Medicare PIN
NH30206885Medicaid
NH32259YMedicare UPIN