MEDICARE: FELICIA RENEE 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	27304	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5902172	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1578867099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FELICIA RENEE YOUNG

Provider Business Mailing Address
First Line	:	10001 W BELLFORT ST
Second Line	:	STE. K
City	:	HOUSTON
State	:	TX
Zip	:	77031-2559
Country	:	US
Telephone Number	:	281-741-8358
Fax Number	:	281-741-8486

Provider Business Practice Location Address
First Line	:	10001 W BELLFORT ST STE K
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77031-2559
Country	:	US
Telephone Number	:	281-741-8358
Fax Number	:	281-741-8486

Authorized Official
Title or Position	:	MG
Name	:	FELICIA YOUNG
Credential	:
Telephone Number	:	281-741-8358

Provider Enumeration Date	:	12/23/2010
Last Update Date	:	02/10/2011

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Directions to “FELICIA RENEE YOUNG ” Practice Location

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