Healthcare Provider Details

I. General information

NPI: 1578661146
Provider Name (Legal Business Name): THOMAS L BOYLE PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 SOUTHRIDGE CT STE 100
HURST TX
76053
US

IV. Provider business mailing address

1245 SOUTHRIDGE CT STE 100
HURST TX
76053
US

V. Phone/Fax

Practice location:
  • Phone: 817-282-3323
  • Fax: 817-282-6128
Mailing address:
  • Phone: 817-282-3323
  • Fax: 817-282-6128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23661
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2793
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: