Provider Demographics
NPI:1497532162
Name:YOUNG, STEVEN C JR
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
Last Name:YOUNG
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S GRAVES ST APT 1714
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-4915
Mailing Address - Country:US
Mailing Address - Phone:316-259-4878
Mailing Address - Fax:
Practice Address - Street 1:125 I 30 E STE F
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-7513
Practice Address - Country:US
Practice Address - Phone:469-513-9310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-04143225200000X
TX2179123225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant