MEDICARE: VALLEY VIEW 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)	049903	TX

General Provider Information

NPI Number	:	1821379827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY VIEW INDEPENDENT SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 1305
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76241-1305
Country	:	US
Telephone Number	:	940-668-8923
Fax Number	:	940-668-7361

Provider Business Practice Location Address
First Line	:	200 NEWTON ST
Second Line	:
City	:	VALLEY VIEW
State	:	TX
Zip	:	76272-9716
Country	:	US
Telephone Number	:	940-726-3659
Fax Number	:	940-668-7361

Authorized Official
Title or Position	:	MEDICAID ENROLLMENT SPECIALIST
Name	:	TODD LEVESQUE
Credential	:
Telephone Number	:	208-922-9300

Provider Enumeration Date	:	09/02/2011
Last Update Date	:	09/02/2011

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