Provider Demographics
NPI:1538364625
Name:ZHANG, CHENGRONG (CRNA)
Entity type:Individual
Prefix:
First Name:CHENGRONG
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6806 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5818
Mailing Address - Country:US
Mailing Address - Phone:214-518-9157
Mailing Address - Fax:
Practice Address - Street 1:11910 GREENVILLE AVE # 650
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3596
Practice Address - Country:US
Practice Address - Phone:214-373-9092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX619878367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88331UOtherBCBS
TX191140601Medicaid
TX8K1246Medicare PIN