Provider Demographics
NPI:1871896100
Name:ROBERT MICHAEL YOUNG MD PA
Entity type:Organization
Organization Name:ROBERT MICHAEL YOUNG MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-614-6677
Mailing Address - Street 1:7922 EWING HALSELL DR
Mailing Address - Street 2:SUITE 470
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3862
Mailing Address - Country:US
Mailing Address - Phone:210-614-6677
Mailing Address - Fax:210-614-6445
Practice Address - Street 1:7922 EWING HALSELL DR
Practice Address - Street 2:SUITE 470
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3862
Practice Address - Country:US
Practice Address - Phone:210-614-6677
Practice Address - Fax:210-614-6445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4784207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB124665OtherINDIVIDUAL MEDICARE PIN
TX098585502Medicaid
TX1639177298OtherINDIVIDUAL NPI
TXC23878Medicare UPIN
TXTXB124664Medicare PIN