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General NPI Number Information
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NPI Number | 1699847509
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Entity Type | Organization
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Legal Business Name | YOUNG & YOUNG UROLOGY ASSOCIATES
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 1404 BRISTOL
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City | BRYAN
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State | TX
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Zip | 77802
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Country | US
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Telephone | 979-779-6615
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Fax | 979-823-2785
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Provider Business Mailing Address
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Address Line | PO BOX 3607
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City | BRYAN
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State | TX
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Zip | 77805-3607
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Country | US
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Telephone | 979-779-6615
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Fax | 979-823-2785
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Authorized Official
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Title or Position | OFFICE MANAGEMENT
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Name | MRS. NANCY CARR YOUNG
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Credential | RN, FNP
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Telephone | 979-779-6615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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