Doctor Name: | MR. WILLIE EDWARD BOYD |
NPI Number: | 1912109067 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 315 East Cliffwood Longview, TX - 75603 |
Business Phone Number: | 9036432129 |
Business Fax Number: | 9036430307 |
Mailing Address: | 315 East Cliffwood, LONGVIEW |
State: | TX |
Postal Code: | 75603 |
Phone Number: | 9036432129 |
Fax Number: | 9036430307 |
NPI Enumeration Date: | 06/01/2007 |
NPI Last Update Date: | 12/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 01/22/2008 |
NPI Reactivation Date: | 12/29/2014 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |