Provider Demographics
NPI:1801877642
Name:BOYD, LARRY C (MD)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:C
Last Name:BOYD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 STADIUM DR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TX
Mailing Address - Zip Code:76380-2343
Mailing Address - Country:US
Mailing Address - Phone:940-889-5583
Mailing Address - Fax:940-889-8835
Practice Address - Street 1:201 STADIUM DR
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TX
Practice Address - Zip Code:76380-2343
Practice Address - Country:US
Practice Address - Phone:940-889-5583
Practice Address - Fax:940-889-8835
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6882208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
F60484Medicare UPIN
TXTXB119792Medicare PIN