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NPI Code Detail

MEDICARE: GARY S YOUNG MD

MEDICARE: GARY S YOUNG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology PhysicianN3403TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00979876OTHERTXRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
48CV082OTHERBCBS

General Provider Information

NPI Number : 1528008646
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY S YOUNG MD
Provider Business Mailing Address
First Line : 800 W MAGNOLIA AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4611
Country : US
Telephone Number : 817-759-7000
Fax Number :
Provider Business Practice Location Address
First Line : 1450 8TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4110
Country : US
Telephone Number : 817-702-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 02/05/2020

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