Active NPI
Robin Ray-Long Chang, PH.D.
- Clinical Psychologist
- Waco, TX
National Provider Identifier
1629384557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY - 1182
- Practice address
- 4800 Memorial Dr
BLDG. 7, RM 1C107
Waco, TX 76711-1329 - Phone
- (254) 297-3522
- Fax
- (254) 297-3396
- NPI assigned
- Aug 30, 2010
- Last updated
- Aug 30, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY - 1182 | HI | Primary |
Addresses
Primary practice location
4800 Memorial Dr
BLDG. 7, RM 1C107
Waco, TX 76711-1329
Mailing address
4800 Memorial Dr
BLDG. 7, RM 1C107
Waco, TX 76711-1329
Phone (254) 297-3522
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1182 | Other | HI | HAWAII LICENSURE PSY - 1182 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY - 1182 | HI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283126400000",
"number": "1629384557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 MEMORIAL DR",
"address_2": "BLDG. 7, RM 1C107",
"city": "WACO",
"state": "TX",
"postal_code": "767111329",
"telephone_number": "254-297-3522",
"fax_number": "254-297-3396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 MEMORIAL DR",
"address_2": "BLDG. 7, RM 1C107",
"city": "WACO",
"state": "TX",
"postal_code": "767111329",
"telephone_number": "254-297-3522",
"fax_number": "254-297-3396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "ROBIN",
"middle_name": "RAY-LONG",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-30",
"last_updated": "2010-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "PSY - 1182",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAWAII LICENSURE PSY - 1182",
"identifier": "1182",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.