1073634044 NPI number — WEIMAR INDEPENDENT SCHOOL DISTRICT

Table of content: DR. JONATHAN VAL C. FAGEL D.O. (NPI 1639507510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073634044 NPI number — WEIMAR INDEPENDENT SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEIMAR INDEPENDENT SCHOOL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073634044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
506 W MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEIMAR
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78962-1900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-725-6034
Provider Business Mailing Address Fax Number:
979-725-9765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
506 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEIMAR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78962-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-725-6034
Provider Business Practice Location Address Fax Number:
979-725-9765
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BELLUE
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF SPECIAL EDUCATION
Authorized Official Telephone Number:
979-725-6034

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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