Active NPI
June-Chieh Chang, M.D.
- Legal Medicine
- Conroe, TX
National Provider Identifier
1003813619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- K4020
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037957005 | Medicaid | TX |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| K4020 | TX | MD | Legal Medicine |
Interoperability endpoints
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.