Healthcare Provider Details

I. General information

NPI: 1992720536
Provider Name (Legal Business Name): BOYD MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 12/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 W ROCK ISLAND AVE
BOYD TX
76023-0308
US

IV. Provider business mailing address

PO BOX 935
BOYD TX
76023-0935
US

V. Phone/Fax

Practice location:
  • Phone: 940-433-5122
  • Fax: 940-433-8309
Mailing address:
  • Phone: 940-433-5122
  • Fax: 940-433-8309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY W. MCINTYRE
Title or Position: MD
Credential: MD
Phone: 940-433-5122