Provider Demographics
NPI:1861194151
Name:TREY T. YOUNG, MD, PLLC
Entity type:Organization
Organization Name:TREY T. YOUNG, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:YOUNG,
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-661-7440
Mailing Address - Street 1:100 MEDICAL CENTER PKWY STE 500
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4965
Mailing Address - Country:US
Mailing Address - Phone:936-661-7440
Mailing Address - Fax:
Practice Address - Street 1:100 MEDICAL CENTER PKWY STE 500
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4965
Practice Address - Country:US
Practice Address - Phone:936-661-7440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty