MEDICARE: AQUILLA 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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831416023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AQUILLA ISD

Provider Business Mailing Address
First Line	:	PO BOX 397
Second Line	:
City	:	HILLSBORO
State	:	TX
Zip	:	76645-0397
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	404 N RICHARDS
Second Line	:
City	:	AQUILLA
State	:	TX
Zip	:	76622-2608
Country	:	US
Telephone Number	:	254-582-3814
Fax Number	:

Authorized Official
Title or Position	:	SPECIAL EDUCATION DIRECTOR
Name	:	SUSAN KEEN
Credential	:
Telephone Number	:	254-582-3814

Provider Enumeration Date	:	04/27/2010
Last Update Date	:	04/27/2010

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Directions to “AQUILLA ISD ” Practice Location

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