Provider Demographics
NPI:1538689708
Name:FOLLETT ISD
Entity Type:Organization
Organization Name:FOLLETT ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRETOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:NINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-653-2301
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:FOLLETT
Mailing Address - State:TX
Mailing Address - Zip Code:79034-0028
Mailing Address - Country:US
Mailing Address - Phone:806-653-2301
Mailing Address - Fax:
Practice Address - Street 1:205 E IVANHOE HIGHWAY 15
Practice Address - Street 2:
Practice Address - City:FOLLETT
Practice Address - State:TX
Practice Address - Zip Code:79034-0028
Practice Address - Country:US
Practice Address - Phone:806-653-2301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid