Provider Demographics
NPI:1356821615
Name:YOUNT, BRIAN ALAN (OTR)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ALAN
Last Name:YOUNT
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 SAN CARLOS AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-2625
Mailing Address - Country:US
Mailing Address - Phone:214-679-3217
Mailing Address - Fax:
Practice Address - Street 1:721 S HIGHWAY 78
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-4004
Practice Address - Country:US
Practice Address - Phone:972-303-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108628225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist