Healthcare Provider Details

I. General information

NPI: 1184683807
Provider Name (Legal Business Name): VALLIANT PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 E LUCAS ST
VALLIANT OK
74764-9076
US

IV. Provider business mailing address

604 E LUCAS ST
VALLIANT OK
74764-9076
US

V. Phone/Fax

Practice location:
  • Phone: 580-933-7232
  • Fax: 580-933-7289
Mailing address:
  • Phone: 580-933-7232
  • Fax: 580-933-7289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBBIE K GOLDEN
Title or Position: SUPERINTENDENT
Credential:
Phone: 580-933-7232