Individual
TIMOTHY NOEL YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5300 NORTH ST, NACOGDOCHES, TX 75965-1370
(936) 569-8278
(936) 569-0275
Mailing address
5300 NORTH ST, NACOGDOCHES, TX 75965-1370
(936) 569-8278
(936) 569-0275
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
N4219
TX
207W00000X
Ophthalmology Physician
Primary
N4219
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2057937-01
—
TX
01
—
P00740176
RR MEDICARE
TX
Enumeration date
08/10/2005
Last updated
10/01/2012
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