MEDICARE: ALBANY 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	:	1891157749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBANY INDEPENDENT SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 2050
Second Line	:
City	:	ALBANY
State	:	TX
Zip	:	76430-8001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 E S 1ST ST
Second Line	:
City	:	ALBANY
State	:	TX
Zip	:	76430-2583
Country	:	US
Telephone Number	:	325-726-2823
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TERRY WYATT
Credential	:
Telephone Number	:	325-773-3637

Provider Enumeration Date	:	03/21/2016
Last Update Date	:	03/21/2016

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Directions to “ALBANY INDEPENDENT SCHOOL DISTRICT ” Practice Location

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