Provider Demographics
NPI:1427186923
Name:YOUNG, MELISSA G (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:G
Last Name:YOUNG
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 1:4435 KINGWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3701
Mailing Address - Country:US
Mailing Address - Phone:281-360-7711
Mailing Address - Fax:281-360-7837
Practice Address - Street 1:4435 KINGWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3701
Practice Address - Country:US
Practice Address - Phone:281-360-7711
Practice Address - Fax:281-360-7837
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH2918207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00D73HMedicare ID - Type Unspecified
C23877Medicare UPIN