CLINIC AT C. C. YOUNG NPI 1104371442

NPI Information

CLINIC AT C. C. YOUNG is an adult medicine family medicine in Dallas, TX. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. CLINIC AT C. C. YOUNG NPI is 1104371442. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Community Clinic At C. C. Young.

The provider's business location address is:

4829 W LAWTHER DR
DALLAS, TX
ZIP 75214-858
Phone: (972) 432-7874

The provider's authorized official is Russell Crews .
The authorized official title is President/ceo and has the following contact phone number (214) 841-2819.

The CLIA number assigned to this NPI record is 45D2121097 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/16/2016 and was last updated on 8/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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