Provider Demographics
NPI:1598996647
Name:YOUNG, ERICA JANEL (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:ERICA
Middle Name:JANEL
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4419 TREASURE TRAIL
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2010
Mailing Address - Country:US
Mailing Address - Phone:713-541-1177
Mailing Address - Fax:713-715-5016
Practice Address - Street 1:4419 TREASURE TRAIL
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2010
Practice Address - Country:US
Practice Address - Phone:713-541-1177
Practice Address - Fax:713-715-5016
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05253363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical