Provider Demographics
NPI:1821514068
Name:YOUNG, JULIA (ATC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:TERESA
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:415 APPLEWHITE RD
Mailing Address - Street 2:
Mailing Address - City:POTEET
Mailing Address - State:TX
Mailing Address - Zip Code:78065-5119
Mailing Address - Country:US
Mailing Address - Phone:832-477-4750
Mailing Address - Fax:
Practice Address - Street 1:415 APPLEWHITE ROAD
Practice Address - Street 2:
Practice Address - City:POTEET
Practice Address - State:TX
Practice Address - Zip Code:78065
Practice Address - Country:US
Practice Address - Phone:832-477-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer