1942343801 NPI number — SANTA ANNA ISD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942343801 NPI number — SANTA ANNA ISD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANTA ANNA 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:
6
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:
1942343801
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3336
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROWNWOOD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76803-3336
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
325-643-4813
Provider Business Mailing Address Fax Number:
325-643-6403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 BOWIE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA ANNA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76878-2513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-643-4813
Provider Business Practice Location Address Fax Number:
325-643-6403
Provider Enumeration Date:
02/14/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LANCASTER
Authorized Official First Name:
JOHNNIE
Authorized Official Middle Name:
SUE
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
325-643-4813

Provider Taxonomy Codes

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

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