MEDICARE: DR. MITCHELL YOUNG

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	2084P0800X	Psychiatry Physician	F0359	TX

General Provider Information

NPI Number	:	1477687937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL YOUNG

Provider Business Mailing Address
First Line	:	1118 BARKDULL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-6402
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1118 BARKDULL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-6402
Country	:	US
Telephone Number	:	713-522-4505
Fax Number	:	713-522-1447

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. MITCHELL YOUNG ” Practice Location

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