MEDICARE: ALTO INDEPENDENT SCHOOL DISTRICT

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	:	1477996593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTO INDEPENDENT SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	244 COUNTY ROAD 2429
Second Line	:
City	:	ALTO
State	:	TX
Zip	:	75925-4247
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	244 COUNTY ROAD 2429
Second Line	:
City	:	ALTO
State	:	TX
Zip	:	75925-4247
Country	:	US
Telephone Number	:	903-683-4466
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	KELLY ROBERTSON
Credential	:
Telephone Number	:	936-858-7103

Provider Enumeration Date	:	04/08/2013
Last Update Date	:	04/08/2013

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Directions to “ALTO INDEPENDENT SCHOOL DISTRICT ” Practice Location

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