Provider Demographics
NPI:1508082652
Name:YOUNG, PATRICK G (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:G
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 TURNER AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-3742
Mailing Address - Country:US
Mailing Address - Phone:214-924-8551
Mailing Address - Fax:
Practice Address - Street 1:8111 LYNDON B JOHNSON FWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-1313
Practice Address - Country:US
Practice Address - Phone:214-366-9407
Practice Address - Fax:214-366-9417
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG15932084P0015X, 2084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1226920Medicaid
TX8L2342Medicare PIN
TX1226920Medicaid
TX8407B7Medicare ID - Type Unspecified
TX00R17CMedicare PIN