Provider Demographics
NPI:1851490635
Name:BOYD, SUZETTE L (MD)
Entity Type:Individual
Prefix:
First Name:SUZETTE
Middle Name:L
Last Name:BOYD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 LEGACY DR
Mailing Address - Street 2:STE 100
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6281
Mailing Address - Country:US
Mailing Address - Phone:214-618-4170
Mailing Address - Fax:214-618-4171
Practice Address - Street 1:3010 LEGACY DR
Practice Address - Street 2:STE 100
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6281
Practice Address - Country:US
Practice Address - Phone:214-618-4170
Practice Address - Fax:214-618-4171
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK0265207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0059JLOtherBLUE CROSS BLUE SHIELD TX
TX1088674OtherCIGNA
TX2979881OtherAETNA
TX1088674OtherCIGNA
TX2979881OtherAETNA