MEDICARE: DR. BOYD DARYL LYLES JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	F4229	TX

General Provider Information

NPI Number	:	1134274285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BOYD DARYL LYLES JR. M.D.

Provider Business Mailing Address
First Line	:	PO BOX 670689
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75367-0689
Country	:	US
Telephone Number	:	469-398-3398
Fax Number	:	469-916-1824

Provider Business Practice Location Address
First Line	:	10670 N CENTRAL EXPY
Second Line	:	SUITE 700
City	:	DALLAS
State	:	TX
Zip	:	75231-2111
Country	:	US
Telephone Number	:	469-398-3398
Fax Number	:	469-916-1824

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	08/27/2010

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