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General NPI Number Information
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NPI Number | 1952335259
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Entity Type | Individual
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Provider Name | DONALD JEFFREY YOUNG M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 405 LONDONDERRY DR STE 301
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City | WACO
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State | TX
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Zip | 76712-7922
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Country | US
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Telephone | 254-741-6333
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Fax | 254-741-6364
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Provider Business Mailing Address
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Address Line | 405 LONDONDERRY DR STE 301
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City | WACO
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State | TX
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Zip | 76712-7922
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Country | US
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Telephone | 254-741-6333
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Fax | 254-741-6364
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | H6724
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | H6724
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | H6724
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License Number State | TX
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