Organization
CLINIC AT C. C. YOUNG
Active
Other names
COMMUNITY CLINIC AT C. C. YOUNG
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL CREWS (PRESIDENT/CEO)
(214) 841-2819
Entity
Organization
Contact information
Practice address
4829 W LAWTHER DR, DALLAS, TX 75214-1858
(972) 432-7874
Mailing address
4847 W LAWTHER DR, SUITE 100, DALLAS, TX 75214-1853
(214) 827-8080
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
645300
TX
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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