Healthcare Provider Details

I. General information

NPI: 1245372960
Provider Name (Legal Business Name): ZEPHYR ISD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11625 COUNTY ROAD 281
ZEPHYR TX
76890-3801
US

IV. Provider business mailing address

P.O. BOX 3336
EARLY TX
76803-3336
US

V. Phone/Fax

Practice location:
  • Phone: 325-643-4813
  • Fax: 325-643-6403
Mailing address:
  • Phone: 325-643-4813
  • Fax: 325-643-6403

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: JOHNNIE SUE LANCASTER
Title or Position: DIRECTOR
Credential:
Phone: 325-643-4813