MEDICARE: FORT STOCKTON 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	:	1558401653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT STOCKTON ISD

Provider Business Mailing Address
First Line	:	1200 W 2ND ST
Second Line	:
City	:	FORT STOCKTON
State	:	TX
Zip	:	79735-6432
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 W 2ND ST
Second Line	:
City	:	FORT STOCKTON
State	:	TX
Zip	:	79735-6432
Country	:	US
Telephone Number	:	432-336-4040
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MARIA GOMEZ
Credential	:
Telephone Number	:	432-336-4000

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	08/22/2020

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Directions to “FORT STOCKTON ISD ” Practice Location

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