Individual provider Active NPI

June-Chieh Chang, M.D.

  • Legal Medicine
  • Conroe, TX
National Provider Identifier
1003813619
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
K4020 Issued in TX
Practice address
100 Medical Center Blvd
Ste 102
Conroe, TX 77304-2821
Phone
(936) 756-9522
Fax
(936) 756-9523
NPI assigned
Jun 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K4020 TX
Pediatrics Physician 208000000X K4020 TX
Legal Medicine 173000000X K4020 TX Primary

Addresses

Primary practice location

100 Medical Center Blvd
Ste 102
Conroe, TX 77304-2821

Mailing address

100 Medical Center Blvd
Ste 102
Conroe, TX 77304-2821
Phone (936) 756-9522

Other identifiers 1

IdentifierTypeStateIssuer
037957005MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040920001148 TX Practitioner - Internal Medicine 8426026253 Practice locations: Conroe, TX

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Medical Ctr Blvd
Suite 102
Conroe, TX 77304-2821
Phone (936) 756-9522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K4020TXMDLegal Medicine

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17348/brand/1/csg/1/fhir/r4

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1003813619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER BLVD",
            "address_2": "STE 102",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042821",
            "telephone_number": "936-756-9522",
            "fax_number": "936-756-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER BLVD",
            "address_2": "STE 102",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042821",
            "telephone_number": "936-756-9522",
            "fax_number": "936-756-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JUNE-CHIEH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-29",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K4020",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K4020",
            "primary": false
        },
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "TX",
            "license": "K4020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037957005",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.