Provider Demographics
NPI:1922191964
Name:YOUNG, DONALD CLAUDE III (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:CLAUDE
Last Name:YOUNG
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 W 20TH ST
Mailing Address - Street 2:STE 210
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2400
Mailing Address - Country:US
Mailing Address - Phone:713-862-3425
Mailing Address - Fax:
Practice Address - Street 1:427 W 20TH ST
Practice Address - Street 2:STE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2400
Practice Address - Country:US
Practice Address - Phone:713-862-3425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4718207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00LJ25OtherBLUE CROSS BLUE SHIELD
00542JMedicare ID - Type Unspecified
D69310Medicare UPIN