Provider Demographics
NPI:1700012143
Name:DELJOUI YOUNG, KATY M (MD)
Entity Type:Individual
Prefix:DR
First Name:KATY
Middle Name:M
Last Name:DELJOUI YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATAYOUN
Other - Middle Name:
Other - Last Name:DELJOUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6565 FANNIN ST
Mailing Address - Street 2:SUITE 1003
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2703
Mailing Address - Country:US
Mailing Address - Phone:713-441-1100
Mailing Address - Fax:713-790-6334
Practice Address - Street 1:6565 FANNIN ST
Practice Address - Street 2:SUITE 1003
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2703
Practice Address - Country:US
Practice Address - Phone:713-441-1100
Practice Address - Fax:713-790-6334
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0242207RC0200X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX341816203Medicaid
TX8FD219OtherBLUE CROSS BLUE SHIELD
TX8FD219OtherBLUE CROSS BLUE SHIELD