MEDICARE: GOLDTHWAITE ISD

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1306967203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDTHWAITE ISD

Provider Business Mailing Address
First Line	:	PO BOX 608
Second Line	:
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844-0608
Country	:	US
Telephone Number	:	325-648-3531
Fax Number	:

Provider Business Practice Location Address
First Line	:	1509 HANNA VALLEY
Second Line	:
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844
Country	:	US
Telephone Number	:	325-648-3531
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MRS. JUDY KING
Credential	:
Telephone Number	:	325-648-3531

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	08/22/2020

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