Provider Demographics
NPI:1376683201
Name:NACOGDOCHES INDEPENDENT SCHOOL DISTRICT
Entity Type:Organization
Organization Name:NACOGDOCHES INDEPENDENT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST MEDICAID CLERK
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-569-3150
Mailing Address - Street 1:609 N MOUND ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-5039
Mailing Address - Country:US
Mailing Address - Phone:936-569-3150
Mailing Address - Fax:936-569-3162
Practice Address - Street 1:609 N MOUND ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-5039
Practice Address - Country:US
Practice Address - Phone:936-569-3150
Practice Address - Fax:936-569-3162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)