Healthcare Provider Details

I. General information

NPI: 1871712505
Provider Name (Legal Business Name): PROGESO ISD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E US HIGHWAY 281
PROGRESO TX
78579-9800
US

IV. Provider business mailing address

PO BOX 610
PROGRESO TX
78579-0610
US

V. Phone/Fax

Practice location:
  • Phone: 956-565-2128
  • Fax: 956-565-1602
Mailing address:
  • Phone: 956-565-2128
  • Fax: 956-565-1602

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: MS. GLORIA KOEPKE
Title or Position: SPECIAL EDUCATION DIRECTOR
Credential: M.ED.
Phone: 956-565-0281