Provider Demographics
NPI:1639267032
Name:MCNABB, BOYD HAL (DDS)
Entity Type:Individual
Prefix:
First Name:BOYD
Middle Name:HAL
Last Name:MCNABB
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:B
Other - Middle Name:HAL
Other - Last Name:MCNABB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1107 MARTIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-2017
Mailing Address - Country:US
Mailing Address - Phone:832-814-6960
Mailing Address - Fax:
Practice Address - Street 1:550 WESTCOTT ST
Practice Address - Street 2:SUITE 448
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5043
Practice Address - Country:US
Practice Address - Phone:713-975-9933
Practice Address - Fax:713-802-1044
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX153511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice