Provider Demographics
NPI:1679586325
Name:DTD DEVELOPMENT LLC
Entity type:Organization
Organization Name:DTD DEVELOPMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:N
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-608-4182
Mailing Address - Street 1:1400 LONE OAK WAY
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-3865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7100 TRAIL LAKE DR.
Practice Address - Street 2:
Practice Address - City:FT. WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133
Practice Address - Country:US
Practice Address - Phone:214-608-4182
Practice Address - Fax:817-263-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014648Medicaid
TX001014648Medicaid