Individual
DERICK WAYNE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5301 39TH ST, GROVES, TX 77619-2911
(409) 962-4272
(409) 962-2451
Mailing address
5301 39TH ST, GROVES, TX 77619-2911
(409) 962-4272
(409) 962-2451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L1502
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144036402
WELLMED MEDICAID
TX
01
—
TXB124736
WELLMED MEDICARE
TX
Enumeration date
07/22/2005
Last updated
02/09/2024
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