Provider Demographics
NPI:1164789095
Name:MILLSAP INDEPENDENT SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MILLSAP INDEPENDENT SCHOOL DISTRICT
Other - Org Name:MILLSAP ISD
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BELDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-682-3101
Mailing Address - Street 1:201 E BRAZOS ST
Mailing Address - Street 2:
Mailing Address - City:MILLSAP
Mailing Address - State:TX
Mailing Address - Zip Code:76066-2360
Mailing Address - Country:US
Mailing Address - Phone:940-682-3101
Mailing Address - Fax:
Practice Address - Street 1:201 E BRAZOS ST
Practice Address - Street 2:
Practice Address - City:MILLSAP
Practice Address - State:TX
Practice Address - Zip Code:76066-2360
Practice Address - Country:US
Practice Address - Phone:940-682-3101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX064900602Medicaid