Provider Demographics
NPI:1386080059
Name:BOYKO, TATIANA VIKTOROVNA (MD)
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:VIKTOROVNA
Last Name:BOYKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TATIANA
Other - Middle Name:VIKTOROVNA
Other - Last Name:MOROZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:923 COLLEGE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3051
Mailing Address - Country:US
Mailing Address - Phone:176-974-0388
Mailing Address - Fax:877-409-3962
Practice Address - Street 1:923 COLLEGE AVE STE 101
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3051
Practice Address - Country:US
Practice Address - Phone:176-974-0388
Practice Address - Fax:877-409-3962
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT4128208600000X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No208600000XAllopathic & Osteopathic PhysiciansSurgery