Provider Demographics
NPI:1669174397
Name:CHANGEH, ERIC MUH (APRN)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:MUH
Last Name:CHANGEH
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6517 GLEBE PATH
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-6032
Mailing Address - Country:US
Mailing Address - Phone:512-767-3711
Mailing Address - Fax:
Practice Address - Street 1:6517 GLEBE PATH
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-6032
Practice Address - Country:US
Practice Address - Phone:512-767-3711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1113036363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health