Provider Demographics
NPI:1447785142
Name:YOUNG, ISABEL ALICIA (PT)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:ALICIA
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11122 CEDARHURST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-6208
Mailing Address - Country:US
Mailing Address - Phone:713-320-5933
Mailing Address - Fax:
Practice Address - Street 1:5757 WOODWAY DR STE 140
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-1519
Practice Address - Country:US
Practice Address - Phone:713-840-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX1279977225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist