Provider Demographics
NPI:1174766059
Name:CHANG, VICTORIA SHIH-HUEI (DO)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:SHIH-HUEI
Last Name:CHANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 BLANCO RD
Mailing Address - Street 2:SUITE 503
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4936
Mailing Address - Country:US
Mailing Address - Phone:210-733-0990
Mailing Address - Fax:210-733-9603
Practice Address - Street 1:7300 BLANCO RD
Practice Address - Street 2:SUITE 503
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4936
Practice Address - Country:US
Practice Address - Phone:210-733-0990
Practice Address - Fax:210-733-9603
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP7750207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program