Provider Demographics
NPI:1215933684
Name:IN, YOUNG G (MD)
Entity type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:G
Last Name:IN
Suffix:
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 1:3480 FANNIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-3804
Mailing Address - Country:US
Mailing Address - Phone:409-833-7585
Mailing Address - Fax:
Practice Address - Street 1:3480 FANNIN ST STE A
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-3804
Practice Address - Country:US
Practice Address - Phone:409-833-7585
Practice Address - Fax:409-833-7760
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6435207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine