Provider Demographics
NPI:1548343452
Name:YOUNG, PATTY K (MD)
Entity type:Individual
Prefix:DR
First Name:PATTY
Middle Name:K
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 W. 15TH ST.
Mailing Address - Street 2:STE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:972-398-1131
Mailing Address - Fax:972-398-0199
Practice Address - Street 1:4104 W. 15TH ST.
Practice Address - Street 2:STE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-398-1131
Practice Address - Fax:972-398-0199
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH55042086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0054BUOtherBCBS
TX0054BUOtherBCBS
TXF59191Medicare UPIN