Provider Demographics
NPI:1730672064
Name:BOYD, HEATHER RENEE
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RENEE
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 NE WILSHIRE BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4147
Mailing Address - Country:US
Mailing Address - Phone:817-447-2717
Mailing Address - Fax:817-447-2731
Practice Address - Street 1:228 NE WILSHIRE BLVD STE C
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-4147
Practice Address - Country:US
Practice Address - Phone:817-447-2717
Practice Address - Fax:817-447-2731
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0117893747P1801X, 3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant