Marcy Eileen Youngdahl, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

P2405 Issued in TX

Practice address

1 Trinity PL # 80
San Antonio, TX 78212-4674

Phone

(210) 999-8111

NPI assigned

May 21, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1407081367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TRINITY PL # 80",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782127200",
            "telephone_number": "210-999-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TRINITY PL # 80",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124674",
            "telephone_number": "210-999-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGDAHL",
        "first_name": "MARCY",
        "middle_name": "EILEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P2405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304509801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Young
• Zachery Young, CRNA
• Guy Youngblood, MD
• John Wade Youngblood Jr., M.D.
• Lloyd Angus Youngblood, MD
• Lindsay D Younger, FNP
• Matthew James Younger, RN
• Michael Yount
• Morgan Elaine Yount
• Stacy Yount, BA, HIS

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.