MEDICARE: DAVID YOUNGER, PC

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	103TC0700X	Clinical Psychologist	36218	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	017592	OTHER	NY	NEW YORK PSYCHOLOGIST LICENSE
2	36218	OTHER	TX	TEXAS PSYCHOLOGY LICENSE
3	1215109194	OTHER	TX	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1700028164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID YOUNGER, PC

Provider Business Mailing Address
First Line	:	2801 CEDARVIEW DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-4606
Country	:	US
Telephone Number	:	914-330-6463
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 CEDARVIEW DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-4606
Country	:	US
Telephone Number	:	914-330-6463
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	DR. DAVID BATKIN YOUNGER
Credential	:	PHD
Telephone Number	:	914-330-6463

Provider Enumeration Date	:	04/01/2009
Last Update Date	:	04/26/2016

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