Healthcare Provider Details

I. General information

NPI: 1326189689
Provider Name (Legal Business Name): ANAHUAC ISD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 WILCOX STREET
ANAHUAC TX
77514-1270
US

IV. Provider business mailing address

PO BOX 1270
ANAHUAC TX
77514-1270
US

V. Phone/Fax

Practice location:
  • Phone: 409-267-3600
  • Fax: 409-267-2019
Mailing address:
  • Phone: 409-267-3600
  • Fax: 409-267-2019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MR. DICK WALKER
Title or Position: BUSINESS MANAGER
Credential:
Phone: 409-267-3600