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Individual

DR. ANDREW JOHN YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
116 IMPERIAL DR, STE A, VICTORIA, TX 77901-3948
(361) 578-2777
(361) 578-2778
Mailing address
116 IMPERIAL DR, STE A, VICTORIA, TX 77901-3948
(361) 578-2777
(361) 578-2778

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
1551
TX
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
1551
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
1551
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
151244401
TX
01
84532N
BCBS PROVIDER NUMBER
TX
01
P00140108
RAILROAD MEDICARE
TX
Enumeration date
06/09/2005
Last updated
09/01/2020
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