MEDICARE: MYKEL BOYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1477143964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYKEL BOYD

Provider Business Mailing Address
First Line	:	15330 LYNDON B JOHNSON FWY STE 101
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75150-1200
Country	:	US
Telephone Number	:	697-098-2154
Fax Number	:

Provider Business Practice Location Address
First Line	:	15330 LYNDON B JOHNSON FWY STE 101
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75150-1200
Country	:	US
Telephone Number	:	697-098-2154
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2021
Last Update Date	:	01/19/2021

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Directions to “ MYKEL BOYD ” Practice Location

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