Provider Demographics
NPI:1497973390
Name:PREMONT ISD
Entity Type:Organization
Organization Name:PREMONT ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL PROGRAMS
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CANALES
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR
Authorized Official - Phone:361-348-3915
Mailing Address - Street 1:PO BOX 530
Mailing Address - Street 2:439 SW 4TH STREET
Mailing Address - City:PREMONT
Mailing Address - State:TX
Mailing Address - Zip Code:78375-0530
Mailing Address - Country:US
Mailing Address - Phone:361-348-3915
Mailing Address - Fax:361-348-2882
Practice Address - Street 1:439 SW 4TH STREET
Practice Address - Street 2:
Practice Address - City:PREMONT
Practice Address - State:TX
Practice Address - Zip Code:78375-0530
Practice Address - Country:US
Practice Address - Phone:361-348-3915
Practice Address - Fax:361-348-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)