Provider Demographics
NPI:1336329150
Name:ALBERT BOYD MD PA
Entity Type:Organization
Organization Name:ALBERT BOYD MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-296-7500
Mailing Address - Street 1:941 YORK DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2066
Mailing Address - Country:US
Mailing Address - Phone:972-296-7500
Mailing Address - Fax:972-296-7588
Practice Address - Street 1:941 YORK DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2066
Practice Address - Country:US
Practice Address - Phone:972-296-7500
Practice Address - Fax:972-296-7588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7315207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00793VMedicare PIN