MEDICARE: INGRAM INDEPENDENT SCHOOL DISTRICT

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	:	1952442642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INGRAM INDEPENDENT SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	510 COLLEGE ST
Second Line	:
City	:	INGRAM
State	:	TX
Zip	:	78025-3207
Country	:	US
Telephone Number	:	830-367-5517
Fax Number	:	830-367-4869

Provider Business Practice Location Address
First Line	:	510 COLLEGE ST
Second Line	:
City	:	INGRAM
State	:	TX
Zip	:	78025-3207
Country	:	US
Telephone Number	:	830-367-5517
Fax Number	:	830-367-4869

Authorized Official
Title or Position	:	ASSISTANT SUPERINTENDENT CFO
Name	:	MR. DAVID D DWORSKY
Credential	:
Telephone Number	:	830-367-5517

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

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Directions to “INGRAM INDEPENDENT SCHOOL DISTRICT ” Practice Location

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