Provider Demographics
NPI:1346970993
Name:YOUNGS, CHRISTIE ZATOPEK
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:ZATOPEK
Last Name:YOUNGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2111 HURLEY AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-1827
Mailing Address - Country:US
Mailing Address - Phone:817-938-4448
Mailing Address - Fax:
Practice Address - Street 1:215 NE 14TH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76164-8901
Practice Address - Country:US
Practice Address - Phone:817-938-4448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX659249401Medicaid