MEDICARE: CARL YOUNG M.D.

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	J2430	TX

General Provider Information

NPI Number	:	1588860225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL YOUNG M.D.

Provider Business Mailing Address
First Line	:	1405 MOCKINGBIRD DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-4831
Country	:	US
Telephone Number	:	214-773-5057
Fax Number	:	972-661-0694

Provider Business Practice Location Address
First Line	:	6750 HILLCREST PLAZA DR
Second Line	:	SUITE 306
City	:	DALLAS
State	:	TX
Zip	:	75230-1400
Country	:	US
Telephone Number	:	972-661-0605
Fax Number	:	972-661-0694

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

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	07/08/2007

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