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General NPI Number Information
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NPI Number | 1851076814
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Entity Type | Individual
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Provider Name | COLBY BOYKO PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 13601 PRESTON RD STE 210W
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City | DALLAS
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State | TX
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Zip | 75240-4986
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Country | US
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Telephone | 832-835-5435
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Fax |
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Provider Business Mailing Address
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Address Line | 9 HOME PLACE CT
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City | DALWORTHINGTON GARDENS
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State | TX
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Zip | 76016-3913
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Country | US
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Telephone | 682-367-7323
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 1377908
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License Number State | TX
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