Provider Demographics
NPI:1255366019
Name:YOUNG, ROBERT MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2870 LEWIS LN
Mailing Address - Street 2:STE 228
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-9380
Mailing Address - Country:US
Mailing Address - Phone:903-785-1346
Mailing Address - Fax:903-785-1481
Practice Address - Street 1:2870 LEWIS LN
Practice Address - Street 2:SUITE 228
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-9380
Practice Address - Country:US
Practice Address - Phone:903-785-1346
Practice Address - Fax:903-785-1481
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH2919208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5525396OtherAETNA
TX020051077OtherMEDICARE RAILROAD
TXP000279L4Medicaid
TX0019ENOtherBCBS
TX020051077OtherMEDICARE RAILROAD
TX0019ENOtherBCBS