Individual
DAVID L YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 OLYMPIC PLAZA CIR, SUITE 510, TYLER, TX 75701-1951
(903) 595-2636
(903) 595-5560
Mailing address
700 OLYMPIC PLAZA CIR, SUITE 510, TYLER, TX 75701-1951
(903) 595-2636
(903) 595-5560
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K8591
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U48Z
GROUP MEDICARE NUMBER
TX
05
—
038850603
—
TX
01
—
085672602
GROUP MEDICAID NUMBER
TX
01
—
752605101
FEIN
TX
01
—
8J9152
INDIVIDUAL MEDICARE NUMBER
TX
Enumeration date
07/17/2006
Last updated
08/18/2020
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