MEDICARE: ROBERT MICHAEL YOUNG MD PA

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
1	207V00000X	Obstetrics & Gynecology Physician	E4784	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TXB124665	OTHER	TX	INDIVIDUAL MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1639177298	OTHER	TX	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1871896100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT MICHAEL YOUNG MD PA

Provider Business Mailing Address
First Line	:	7922 EWING HALSELL DR
Second Line	:	SUITE 470
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3862
Country	:	US
Telephone Number	:	210-614-6677
Fax Number	:	210-614-6445

Provider Business Practice Location Address
First Line	:	7922 EWING HALSELL DR
Second Line	:	SUITE 470
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3862
Country	:	US
Telephone Number	:	210-614-6677
Fax Number	:	210-614-6445

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. ROBERT MICHAEL YOUNG
Credential	:	MD
Telephone Number	:	210-614-6677

Provider Enumeration Date	:	12/08/2010
Last Update Date	:	01/31/2012

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Directions to “ROBERT MICHAEL YOUNG MD PA ” Practice Location

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