Healthcare Provider Details

I. General information

NPI: 1376687616
Provider Name (Legal Business Name): SPRINGTOWN ISD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E 2ND ST
SPRINGTOWN TX
76082-2457
US

IV. Provider business mailing address

101 E 2ND ST
SPRINGTOWN TX
76082-2457
US

V. Phone/Fax

Practice location:
  • Phone: 817-523-0643
  • Fax: 817-523-5875
Mailing address:
  • Phone: 817-523-0643
  • Fax: 817-523-5875

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: MRS. STACY JOHNSON
Title or Position: DIRECTOR OF SPECIAL EDUCATION
Credential:
Phone: 817-523-0643