Healthcare Provider Details

I. General information

NPI: 1134345416
Provider Name (Legal Business Name): MELISSA ISD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 COOPER ST
MELISSA TX
75454-9555
US

IV. Provider business mailing address

1404 N MCDONALD ST
MCKINNEY TX
75071-1822
US

V. Phone/Fax

Practice location:
  • Phone: 972-837-2411
  • Fax:
Mailing address:
  • Phone: 972-548-3200
  • Fax: 214-544-2001

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: ROSEMARY CASKEY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 972-837-2411