Boyznberry Corporation
Organization Active NPI Contractor · Mansfield, TX
NPI 1447469986 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1447469986
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Contractor 171W00000X
- License
- 1027654 (TX)
- Legal business name
- BOYZNBERRY CORPORATION
- Practice address
- 4003 Calloway Dr
Mansfield, TX 76063-3448 - Phone
- (817) 727-3182
- Fax
- (682) 518-5603
- NPI assigned
- May 22, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Stan E Blackburn, MS,PT
- Title
- President
- Phone
- (817) 727-3182
Practitioners 1
-
Stan E. Blackburn, MS, PT
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor |
171W00000X | 1027654 | TX | Yes |
Addresses
Primary practice location
4003 Calloway Dr
Mansfield, TX 76063-3448
Mailing address
4003 Calloway Dr
Mansfield, TX 76063-3448
Phone (817) 727-3182
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1027654 | Other | TX | PHYSICAL THERAPIST |
Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.