MEDICARE: DTD DEVELOPMENT LLC

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	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679586325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DTD DEVELOPMENT LLC

Provider Business Mailing Address
First Line	:	1400 LONE OAK WAY
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-3865
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7100 TRAIL LAKE DR.
Second Line	:
City	:	FT. WORTH
State	:	TX
Zip	:	76133
Country	:	US
Telephone Number	:	214-608-4182
Fax Number	:	817-263-2220

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TERENCE N. BOYD
Credential	:
Telephone Number	:	214-608-4182

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	04/15/2013

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Directions to “DTD DEVELOPMENT LLC ” Practice Location

Language	Start Address	Practice Location

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