Provider Demographics
NPI:1316284920
Name:BOYD, MARY GARCIA (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:GARCIA
Last Name:BOYD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8935 RED CLOUD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-7140
Mailing Address - Country:US
Mailing Address - Phone:713-540-1552
Mailing Address - Fax:
Practice Address - Street 1:12345 JONES RD STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4959
Practice Address - Country:US
Practice Address - Phone:832-663-7541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101848235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist