Provider Demographics
NPI:1639209190
Name:BOYD, DEBORAH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 S COLUMBIA DR
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:TX
Mailing Address - Zip Code:77486-3025
Mailing Address - Country:US
Mailing Address - Phone:979-345-6522
Mailing Address - Fax:979-345-4922
Practice Address - Street 1:513 S COLUMBIA DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:TX
Practice Address - Zip Code:77486-3025
Practice Address - Country:US
Practice Address - Phone:979-345-6522
Practice Address - Fax:979-345-4922
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02401363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical