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General NPI Number Information
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NPI Number | 1912361841
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Entity Type | Organization
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Legal Business Name | BENJAMIN DANIEL BOYNTON PHD PLLC
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 1810 SHILOH RD SUITE 801
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City | TYLER
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State | TX
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Zip | 75703-2419
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Country | US
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Telephone | 903-593-6355
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Fax |
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Provider Business Mailing Address
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Address Line | 2627 S BROADWAY AVE STE 6158
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City | TYLER
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State | TX
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Zip | 75701-5405
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Country | US
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Telephone | 903-330-6166
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. BENJAMIN DANIEL BOYNTON
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Credential | PH.D.
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Telephone | 903-593-6355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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