Provider Demographics
NPI:1790164945
Name:YOUNGBLOOD, AMIE PATEL (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIE
Middle Name:PATEL
Last Name:YOUNGBLOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMIE
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2700 W PECAN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3069
Mailing Address - Country:US
Mailing Address - Phone:512-421-3750
Mailing Address - Fax:512-421-3751
Practice Address - Street 1:2700 W PECAN ST STE 102
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3069
Practice Address - Country:US
Practice Address - Phone:512-421-3750
Practice Address - Fax:512-421-3751
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5178207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine