Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | R0078 | TX |
NPI | 1013352145 |
---|---|
Provider Name | Dr. Young Thi Mcmahan |
First Address | Waco, TX 76712 |
Second Address | Waco, TX 76712-7935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2013 |
Last Update Date | 17/03/2018 |