Provider First Line Business Practice Location Address: 
FABENS ISD SPECIAL EDUCATION
    Provider Second Line Business Practice Location Address: 
603 NE CAMP ST.
    Provider Business Practice Location Address City Name: 
FABENS
    Provider Business Practice Location Address State Name: 
TX
    Provider Business Practice Location Address Postal Code: 
79838
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
915-765-2690
    Provider Business Practice Location Address Fax Number: 
915-765-3744
    Provider Enumeration Date: 
08/25/2015