Provider Demographics
NPI:1477042703
Name:GLENN A. BOYD, O.D. ,P.A.
Entity Type:Organization
Organization Name:GLENN A. BOYD, O.D. ,P.A.
Other - Org Name:EYE MATTERS BY BOYD EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LASATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-557-3937
Mailing Address - Street 1:1560 HIGHWAY 287 N STE 300
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8824
Mailing Address - Country:US
Mailing Address - Phone:817-557-3937
Mailing Address - Fax:817-473-0950
Practice Address - Street 1:700 SILKEN XING STE 2002
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-5595
Practice Address - Country:US
Practice Address - Phone:972-723-2727
Practice Address - Fax:972-775-6539
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLENN A. BOYD, O.D. ,P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3321TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty