Provider Demographics
NPI:1407159270
Name:ROBERT M. YOUNG, M.D.,P.A.
Entity Type:Organization
Organization Name:ROBERT M. YOUNG, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-785-1346
Mailing Address - Street 1:2870 LEWIS LANE
Mailing Address - Street 2:SUITE 228
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-9380
Mailing Address - Country:US
Mailing Address - Phone:903-785-1346
Mailing Address - Fax:903-785-1481
Practice Address - Street 1:2870 LEWIS LANE
Practice Address - Street 2:SUITE 228
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-9380
Practice Address - Country:US
Practice Address - Phone:903-785-1346
Practice Address - Fax:903-785-1481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000279L4Medicaid
TX00279LMedicare UPIN