MEDICARE: CADDO PARISH SCHOOL BOARD

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)

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

General Provider Information

NPI Number	:	1639200165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CADDO PARISH SCHOOL BOARD

Provider Business Mailing Address
First Line	:	3004 KNIGHT ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2502
Country	:	US
Telephone Number	:	318-219-0191
Fax Number	:	318-868-7039

Provider Business Practice Location Address
First Line	:	3004 KNIGHT ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2502
Country	:	US
Telephone Number	:	318-219-0191
Fax Number	:	318-868-7039

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MS. OLLIE S TYLER
Credential	:
Telephone Number	:	318-603-6509

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	08/22/2020

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Directions to “CADDO PARISH SCHOOL BOARD ” Practice Location

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