1588793459 NPI number — HOUSTON R-1 SCHOOL DISTRICT

Table of content: (NPI 1588793459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588793459 NPI number — HOUSTON R-1 SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSTON R-1 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:
1588793459
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
423 W. PINE ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65483
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-967-3196
Provider Business Mailing Address Fax Number:
417-967-4479

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
204 W. SPRUCE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-967-3196
Provider Business Practice Location Address Fax Number:
417-967-4479
Provider Enumeration Date:
03/05/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRONTERHOUSE
Authorized Official First Name:
RUBY
Authorized Official Middle Name:
EILEEN
Authorized Official Title or Position:
DIRECTOR, EXCEPTIONAL CHILD COOP (H
Authorized Official Telephone Number:
417-967-3196

Provider Taxonomy Codes

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

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

  • Identifier: 506108208 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".