Provider Demographics
NPI:1245618834
Name:MCLEAN ISD
Entity Type:Organization
Organization Name:MCLEAN ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-779-2571
Mailing Address - Street 1:PO BOX 90
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:TX
Mailing Address - Zip Code:79057-0090
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4TH AND ROWE STREET
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:TX
Practice Address - Zip Code:79057-0090
Practice Address - Country:US
Practice Address - Phone:806-779-2571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid