Provider Demographics
NPI:1508572470
Name:YOUNG, ANGEL (DPT)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 REINSCH RD
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78957-5502
Mailing Address - Country:US
Mailing Address - Phone:512-423-4981
Mailing Address - Fax:
Practice Address - Street 1:1611 REINSCH RD
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TX
Practice Address - Zip Code:78957-5502
Practice Address - Country:US
Practice Address - Phone:512-423-4981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1309820225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist