Healthcare Provider Details

I. General information

NPI: 1851516801
Provider Name (Legal Business Name): ECTOR COUNTY ISD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 N SAM HOUSTON AVE
ODESSA TX
79761-3973
US

IV. Provider business mailing address

PO BOX 3912
ODESSA TX
79760-3912
US

V. Phone/Fax

Practice location:
  • Phone: 432-332-9151
  • Fax: 432-334-0785
Mailing address:
  • Phone: 432-332-9151
  • Fax: 432-334-0785

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. DAVID HARWELL
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 432-334-7105