Individual
ANGELIQUE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1901 S 24TH AVE, EDINBURG, TX 78539-6533
(956) 289-7025
(956) 513-0409
Mailing address
1901 S 24TH AVE, EDINBURG, TX 78539-6533
(956) 289-7025
(956) 513-0409
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT81357
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00R945
MEDICARE
TX
05
—
138708611
—
TX
05
—
138708613
—
TX
Enumeration date
06/01/2016
Last updated
06/01/2016
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