Provider Demographics
NPI:1114141058
Name:BOYD, CAROLYN L (PTA)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:L
Last Name:BOYD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6511 ASPEN SHORES CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6746
Mailing Address - Country:US
Mailing Address - Phone:361-739-8214
Mailing Address - Fax:
Practice Address - Street 1:3040 POST OAK BLVD
Practice Address - Street 2:#1200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6500
Practice Address - Country:US
Practice Address - Phone:713-965-9998
Practice Address - Fax:713-965-9921
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20540872251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics