Provider Demographics
NPI:1760479596
Name:CHANG-GODINICH, ANNE (MD)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:
Last Name:CHANG-GODINICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13333 DOTSON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4305
Mailing Address - Country:US
Mailing Address - Phone:281-890-1784
Mailing Address - Fax:281-890-5733
Practice Address - Street 1:13333 DOTSON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4305
Practice Address - Country:US
Practice Address - Phone:281-890-1784
Practice Address - Fax:281-890-5733
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1173207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037767301Medicaid
TX8094M1Medicare ID - Type Unspecified