Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 0101252975 | VA |
NPI | 1053603670 |
---|---|
Provider Name | David Chang |
First Address | Jbsa Ft Sam Houston, TX 78234-4504 |
Second Address | Jbsa Ft Sam Houston, TX 78234-4504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2011 |
Last Update Date | 19/02/2016 |