Provider Demographics
NPI:1891815650
Name:GREGORY D. YOUNG, DC
Entity Type:Organization
Organization Name:GREGORY D. YOUNG, DC
Other - Org Name:YOUNG CHIROPRACTIC OF ANDREWS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:432-524-5580
Mailing Address - Street 1:200 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-7115
Mailing Address - Country:US
Mailing Address - Phone:432-524-5580
Mailing Address - Fax:432-524-5583
Practice Address - Street 1:200 SE 1ST ST
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-7115
Practice Address - Country:US
Practice Address - Phone:432-524-5580
Practice Address - Fax:432-524-5583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX607054OtherBCBS
TX609573Medicare ID - Type Unspecified
TXU69709Medicare UPIN