Provider Demographics
NPI:1447650916
Name:YOUNGBLOOD, TONYA (DC)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:
Last Name:YOUNGBLOOD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 N WATSON RD STE 145
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-6223
Mailing Address - Country:US
Mailing Address - Phone:682-270-0002
Mailing Address - Fax:
Practice Address - Street 1:1201 N WATSON RD STE 145
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-6223
Practice Address - Country:US
Practice Address - Phone:682-270-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12735111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor