Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | J8927 | TX |
NPI | 1346334919 |
---|---|
Provider Name | Dr. Teresa Diane Boyd |
First Address | San Antonio, TX 78229 |
Second Address | San Antonio, TX 78229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |