Provider Demographics
NPI:1639177298
Name:YOUNG, ROBERT MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:M
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 692127
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78269-2127
Mailing Address - Country:US
Mailing Address - Phone:210-325-4420
Mailing Address - Fax:210-492-2488
Practice Address - Street 1:7922 EWING HALSELL DR
Practice Address - Street 2:SUITE 470
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3862
Practice Address - Country:US
Practice Address - Phone:210-614-6677
Practice Address - Fax:210-614-6445
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4784207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0985855-02Medicaid
TX1871896100OtherGROUP NPI
TXTXB124665Medicare PIN
TX1871896100OtherGROUP NPI