Organization
YOUNGVAX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNDRA YOUNG (DIRECTOR)
(817) 703-9375
Entity
Organization
Contact information
Practice address
606 HOGAN ALLEY DR, MANSFIELD, TX 76063-5473
(817) 703-9375
Mailing address
606 HOGAN ALLEY DR, MANSFIELD, TX 76063-5473
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
11/06/2013
Last updated
11/06/2013
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