1639205578 NPI number — YOAKUM ISD

Table of content: (NPI 1639205578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639205578 NPI number — YOAKUM ISD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YOAKUM ISD
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:
1639205578
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 737
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YOAKUM
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77995-0737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-293-3162
Provider Business Mailing Address Fax Number:
361-293-6678

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
102 MCKINNON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YOAKUM
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77995-1623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-293-3162
Provider Business Practice Location Address Fax Number:
361-293-6678
Provider Enumeration Date:
02/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PATE
Authorized Official First Name:
LYNETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
361-293-3162

Provider Taxonomy Codes

  • Taxonomy code: 101YS0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 163WS0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 164X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 224Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2355S0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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