Individual
GARY S YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1450 8TH AVE, FORT WORTH, TX 76104-4110
(817) 702-8300
Mailing address
800 W MAGNOLIA AVE, FORT WORTH, TX 76104-4611
(817) 759-7000
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
N3403
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2037335-03
—
TX
05
—
2037335-04
—
TX
01
—
8CV082
BCBS
—
01
—
P00979876
RAILROAD MEDICARE
TX
Enumeration date
06/07/2006
Last updated
02/05/2020
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