Provider Demographics
NPI:1407164163
Name:YOUNG, AMY (CPHT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10375 RICHMOND AVE
Mailing Address - Street 2:SUITE 1575
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4143
Mailing Address - Country:US
Mailing Address - Phone:713-541-1177
Mailing Address - Fax:713-513-5924
Practice Address - Street 1:10375 RICHMOND AVE
Practice Address - Street 2:SUITE 1575
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4143
Practice Address - Country:US
Practice Address - Phone:713-541-1177
Practice Address - Fax:713-513-5924
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX07313351183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician