Provider Demographics
NPI:1922027408
Name:YU, SUSAN YOUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:YOUNG
Last Name:YU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10440 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 124
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2221
Mailing Address - Country:US
Mailing Address - Phone:214-234-0000
Mailing Address - Fax:214-234-7576
Practice Address - Street 1:10440 N CENTRAL EXPY
Practice Address - Street 2:SUITE 124
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2221
Practice Address - Country:US
Practice Address - Phone:214-234-0000
Practice Address - Fax:214-234-7576
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9543111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU97813Medicare UPIN
TX8B3122Medicare ID - Type Unspecified