MEDICARE: DR. ANDREW JOHN YOUNG DPM

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	213E00000X	Podiatrist	1551	TX
2	213ES0103X	Foot & Ankle Surgery Podiatrist	1551	TX
3	213EP1101X	Primary Podiatric Medicine Podiatrist	1551	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00140108	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	84532N	OTHER	TX	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1992709869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW JOHN YOUNG DPM

Provider Business Mailing Address
First Line	:	116 IMPERIAL DR
Second Line	:	STE A
City	:	VICTORIA
State	:	TX
Zip	:	77901-3948
Country	:	US
Telephone Number	:	361-578-2777
Fax Number	:	361-578-2778

Provider Business Practice Location Address
First Line	:	116 IMPERIAL DR
Second Line	:	STE A
City	:	VICTORIA
State	:	TX
Zip	:	77901-3948
Country	:	US
Telephone Number	:	361-578-2777
Fax Number	:	361-578-2778

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	09/01/2020

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Directions to “ DR. ANDREW JOHN YOUNG DPM” Practice Location

Language	Start Address	Practice Location

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