Healthcare Provider Details

I. General information

NPI: 1043790959
Provider Name (Legal Business Name): JENNIFER LEE BOYD PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 SGT ED HOLCOMB BLVD S
CONROE TX
77304-1990
US

IV. Provider business mailing address

38 QUIET OAK CIR
THE WOODLANDS TX
77381-3159
US

V. Phone/Fax

Practice location:
  • Phone: 936-756-8331
  • Fax:
Mailing address:
  • Phone: 832-374-2324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAP137739
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: