Basic Information
Provider Information
NPI: 1215108949
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOUNG
FirstName: DAVID
MiddleName: DARA
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4100 INTERNATIONAL PLAZA
Address2: STE. 600
City: FORT WORTH
State: TX
PostalCode: 761094823
CountryCode: US
TelephoneNumber: 8175291923
FaxNumber: 8178770350
Practice Location
Address1: 3300 OAK LAWN AVE STE 200
Address2:  
City: DALLAS
State: TX
PostalCode: 752194265
CountryCode: US
TelephoneNumber: 2142734114
FaxNumber: 2142520524
Other Information
ProviderEnumerationDate: 03/20/2008
LastUpdateDate: 06/15/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X MAN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207L00000XN8735TXY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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