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General NPI Number Information
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NPI Number | 1972608529
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Entity Type | Individual
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Provider Name | KARON YOUNG-LIGHTBODY MD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 309 HWY 59 SOUTH LOOP
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City | LIVINGSTON
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State | TX
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Zip | 77351
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Country | US
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Telephone | 936-327-1055
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Fax | 281-592-1570
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Provider Business Mailing Address
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Address Line | 108 S. WILLIAM BARNETT AVE.
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City | CLEVELAND
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State | TX
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Zip | 77327
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Country | US
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Telephone | 281-592-9775
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Fax | 281-592-1570
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 101235134
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License Number State | VA
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