MEDICARE: TEXARKANA SPECIAL EDUCATION CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	116956	TX
2	261Q00000X	Clinic/Center	PT1532	AR
3	261Q00000X	Clinic/Center	SP#477	AR
4	261Q00000X	Clinic/Center	1158790	TX
5	261Q00000X	Clinic/Center	100348	TX
6	261Q00000X	Clinic/Center	109611	TX
7	261Q00000X	Clinic/Center	152450	TX
8	261QA0600X	Adult Day Care Clinic/Center	116469	TX
9	261QD1600X	Developmental Disabilities Clinic/Center
10	310400000X	Assisted Living Facility	DDS COMMUNITY PROGRA	AR
11	251C00000X	Developmentally Disabled Services Day Training Agency	DDS COMMUNITY PROGRA	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	0023GT	OTHER	TX	PRIVATE INSURANCE BCBS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174676415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXARKANA SPECIAL EDUCATION CENTER, INC.

Provider Business Mailing Address
First Line	:	6101 N STATE LINE AVE
Second Line	:
City	:	TEXARKANA
State	:	TX
Zip	:	75503-5309
Country	:	US
Telephone Number	:	903-791-2270
Fax Number	:	903-792-0816

Provider Business Practice Location Address
First Line	:	6101 N STATE LINE AVE
Second Line	:
City	:	TEXARKANA
State	:	TX
Zip	:	75503-5309
Country	:	US
Telephone Number	:	903-791-2270
Fax Number	:	903-792-0816

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. SHERRY YOUNG
Credential	:
Telephone Number	:	903-791-2270

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	01/30/2024

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