Provider Demographics
NPI:1851076814
Name:BOYKO, COLBY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:COLBY
Middle Name:
Last Name:BOYKO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HOME PLACE CT
Mailing Address - Street 2:
Mailing Address - City:DALWORTHINGTON GARDENS
Mailing Address - State:TX
Mailing Address - Zip Code:76016-3913
Mailing Address - Country:US
Mailing Address - Phone:682-367-7323
Mailing Address - Fax:
Practice Address - Street 1:13601 PRESTON RD STE 210W
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4986
Practice Address - Country:US
Practice Address - Phone:832-835-5435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13779082251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics