Provider Demographics
NPI:1831667906
Name:BOYD EYE CARE LLC
Entity type:Organization
Organization Name:BOYD EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-557-3937
Mailing Address - Street 1:1560 HIGHWAY 287 N STE 300
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8824
Mailing Address - Country:US
Mailing Address - Phone:817-557-3937
Mailing Address - Fax:817-473-0950
Practice Address - Street 1:1560 HIGHWAY 287 N STE 300
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-8824
Practice Address - Country:US
Practice Address - Phone:817-557-3937
Practice Address - Fax:817-473-0950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX329106401Medicaid
TX197166501Medicaid
TX8DW848OtherBCBS