NPI 1275069478

Jeffrey Joe Young

Practitioner PACE Provider Organization Dickinson, TX

Practice location

Address: 2129 Green Lee Lane, Dickinson, TX 77539-5152
Phone: (972) 308-7450
Mailing address: 2202 Timber Dr., Dickinson, TX 77539-5152

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

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Registry record

NPI: 1275069478
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 May 2017
Record last updated: 8 May 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.