Healthcare Provider Details

I. General information

NPI: 1538285325
Provider Name (Legal Business Name): DAINGERFIELD-LONE STAR ISD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TIGER DR
DAINGERFIELD TX
75638-2500
US

IV. Provider business mailing address

200 TIGER DR
DAINGERFIELD TX
75638-2500
US

V. Phone/Fax

Practice location:
  • Phone: 903-645-2239
  • Fax: 903-645-2137
Mailing address:
  • Phone: 903-645-2239
  • Fax: 903-645-2137

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: RITA MARS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 903-645-2239