Provider Demographics
NPI:1235713223
Name:CHIANG, KEVIN CLEMENT (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:CLEMENT
Last Name:CHIANG
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 1:2222 WELBORN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3924
Mailing Address - Country:US
Mailing Address - Phone:214-559-5000
Mailing Address - Fax:214-443-7309
Practice Address - Street 1:5700 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9580
Practice Address - Country:US
Practice Address - Phone:469-515-7100
Practice Address - Fax:469-515-7101
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1505732080S0010X
390200000X
TXV92922080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program