Provider Demographics
NPI:1063658698
Name:BOYCE, MANDY DE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MANDY
Middle Name:DE ANN
Last Name:BOYCE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 ACCENT DR
Mailing Address - Street 2:APT 1336
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6780
Mailing Address - Country:US
Mailing Address - Phone:972-672-8392
Mailing Address - Fax:
Practice Address - Street 1:1001 E MOORE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-3223
Practice Address - Country:US
Practice Address - Phone:972-563-6781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-03
Last Update Date:2009-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10995111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic