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General NPI Number Information
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NPI Number | 1184110447
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Entity Type | Organization
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Legal Business Name | BUENA VISTA ISD
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 404 HIGHWAY 11 W
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City | IMPERIAL
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State | TX
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Zip | 79743
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Country | US
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Telephone | 432-536-2336
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Fax | 432-536-2469
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Provider Business Mailing Address
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Address Line | PO BOX 310
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City | IMPERIAL
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State | TX
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Zip | 79743-0310
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Country | US
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Telephone | 432-536-2336
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Fax | 432-536-2469
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | JOHN BENAVIDEZ
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Credential |
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Telephone | 432-536-2236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | TX
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