Provider Demographics
NPI:1417019258
Name:YOUN, YOUNG (MD)
Entity Type:Individual
Prefix:
First Name:YOUNG
Middle Name:
Last Name:YOUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HOSPITAL DRIVE #999
Mailing Address - Street 2:
Mailing Address - City:RUSK
Mailing Address - State:TX
Mailing Address - Zip Code:75785
Mailing Address - Country:US
Mailing Address - Phone:903-683-3421
Mailing Address - Fax:
Practice Address - Street 1:1601 DICKINSON DRIVE
Practice Address - Street 2:
Practice Address - City:RUSK
Practice Address - State:TX
Practice Address - Zip Code:75785
Practice Address - Country:US
Practice Address - Phone:903-683-7201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE82392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX43307001Medicaid
TX43307001Medicaid
TX84A612Medicare ID - Type Unspecified