Provider Demographics
NPI:1992215503
Name:SHARLA BOYD, PH.D., PLLC
Entity Type:Organization
Organization Name:SHARLA BOYD, PH.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:806-414-3616
Mailing Address - Street 1:6614 BANGOR AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-1504
Mailing Address - Country:US
Mailing Address - Phone:806-414-3616
Mailing Address - Fax:
Practice Address - Street 1:6824 WAYNE AVE STE 1
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-1649
Practice Address - Country:US
Practice Address - Phone:806-414-3616
Practice Address - Fax:806-203-3297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32168103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty