Healthcare Provider Details

I. General information

NPI: 1265740450
Provider Name (Legal Business Name): CHICO ISD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 PARK RD
CHICO TX
76431
US

IV. Provider business mailing address

1120 PARK RD
CHICO TX
76431
US

V. Phone/Fax

Practice location:
  • Phone: 940-683-8361
  • Fax: 940-683-5849
Mailing address:
  • Phone: 940-683-8361
  • Fax: 940-683-5849

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: JULIE MADDUX
Title or Position: BOOKKEEPER
Credential:
Phone: 940-644-2228