Provider Demographics
NPI:1902011075
Name:CHANG, ALBERT R (DC)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:R
Last Name:CHANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3923 DIAMONDALE CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8006
Mailing Address - Country:US
Mailing Address - Phone:281-895-3987
Mailing Address - Fax:
Practice Address - Street 1:3923 DIAMONDALE CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-8006
Practice Address - Country:US
Practice Address - Phone:281-895-3987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5834111N00000X
CA21867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor