Healthcare Provider Details

I. General information

NPI: 1639436710
Provider Name (Legal Business Name): DR GEORGE B BOYD III DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 04/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7838 BARLITE BLVD
SAN ANTONIO TX
78224-1364
US

IV. Provider business mailing address

7838 BARLITE BLVD
SAN ANTONIO TX
78224-1364
US

V. Phone/Fax

Practice location:
  • Phone: 210-932-9729
  • Fax: 210-855-0522
Mailing address:
  • Phone: 210-932-9729
  • Fax: 210-855-0522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE B BOYD III
Title or Position: PRESIDENT SOLE OWNER OF PLLC
Credential: D.O.
Phone: 210-932-9729