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NPI Code Detail

MEDICARE: MR. STEPHEN E YOUNG JR. PA-C

MEDICARE: MR. STEPHEN E YOUNG JR. PA-C
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
1363A00000XPhysician AssistantPA04720TX

General Provider Information

NPI Number : 1699839621
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN E YOUNG JR. PA-C
Provider Business Mailing Address
First Line : 8701 W PARMER LN APT 1213
Second Line :
City : AUSTIN
State : TX
Zip : 78729-4942
Country : US
Telephone Number : 512-536-0288
Fax Number :
Provider Business Practice Location Address
First Line : 1855 GATTIS SCHOOL RD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-7428
Country : US
Telephone Number : 512-238-6268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 09/27/2021

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