Boyznberry Corporation
Contractor in Mansfield, TX. Organization (NPI-2).
NPI number1447469986
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1447469986
- Entity type
- Organization (NPI-2)
- Legal business name
- Boyznberry Corporation
- Organization subpart
- No
- Enumeration date
- May 22, 2007
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | 1027654 | TX | Yes |
Practice location
4003 Calloway DrMansfield, TX 76063-3448
Phone 817-727-3182 · Fax 682-518-5603
Mailing address
4003 Calloway DrMansfield, TX 76063-3448
Phone 817-727-3182 · Fax 682-518-5603
Authorized official
Stan E Blackburn
President
8177273182
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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