Provider Demographics
NPI:1265140727
Name:YOUNG, DEBORAH ADELE (PBT, CPT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ADELE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PBT, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 FANNIN SPEEDWAY APT 1243
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-5055
Mailing Address - Country:US
Mailing Address - Phone:832-404-3928
Mailing Address - Fax:
Practice Address - Street 1:1818 FANNIN SPEEDWAY APT 1243
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045-5055
Practice Address - Country:US
Practice Address - Phone:832-404-3928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor