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General NPI Number Information
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NPI Number | 1871155101
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Entity Type | Organization
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Legal Business Name | MICHAEL C BOYLE, PLLC
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 1101 RIDGE RD STE 232
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City | ROCKWALL
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State | TX
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Zip | 75087-4250
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Country | US
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Telephone | 469-769-1744
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Fax |
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Provider Business Mailing Address
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Address Line | 918 MANGROVE DR
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City | FATE
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State | TX
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Zip | 75087-6917
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Country | US
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Telephone | 469-769-1744
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Fax |
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Authorized Official
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Title or Position | PHD
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Name | MICHAEL C BOYLE
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Credential | OWNER
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Telephone | 469-769-1744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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