Provider Demographics
NPI:1720679178
Name:CHNG, CASSANDRA TANYA
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:TANYA
Last Name:CHNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 TIMBERCREEK DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-4750
Mailing Address - Country:US
Mailing Address - Phone:214-226-6481
Mailing Address - Fax:
Practice Address - Street 1:5505 ROWLETT RD STE 200
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-4028
Practice Address - Country:US
Practice Address - Phone:469-487-7779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst