Healthcare Provider Details

I. General information

NPI: 1679586325
Provider Name (Legal Business Name): DTD DEVELOPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 04/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 TRAIL LAKE DR.
FT. WORTH TX
76133
US

IV. Provider business mailing address

1400 LONE OAK WAY
FLOWER MOUND TX
75028-3865
US

V. Phone/Fax

Practice location:
  • Phone: 214-608-4182
  • Fax: 817-263-2220
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TERENCE N. BOYD
Title or Position: PRESIDENT
Credential:
Phone: 214-608-4182