MEDICARE: DE LEON ISD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1699819763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DE LEON ISD

Provider Business Mailing Address
First Line	:	601 S HOUSTON ST
Second Line	:
City	:	DE LEON
State	:	TX
Zip	:	76444-2708
Country	:	US
Telephone Number	:	254-893-5095
Fax Number	:	254-893-3101

Provider Business Practice Location Address
First Line	:	601 S HOUSTON ST
Second Line	:
City	:	DE LEON
State	:	TX
Zip	:	76444-2708
Country	:	US
Telephone Number	:	254-893-5095
Fax Number	:	254-893-3101

Authorized Official
Title or Position	:	DIRECTOR OF BUSINESS SERVICES
Name	:	ANGELA D WHITE
Credential	:
Telephone Number	:	254-893-5095

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	08/22/2020

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Directions to “DE LEON ISD ” Practice Location

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