Provider Demographics
NPI:1548610405
Name:THORNDALE ISD
Entity Type:Organization
Organization Name:THORNDALE ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-898-2538
Mailing Address - Street 1:PO BOX 870
Mailing Address - Street 2:
Mailing Address - City:THORNDALE
Mailing Address - State:TX
Mailing Address - Zip Code:76577-0870
Mailing Address - Country:US
Mailing Address - Phone:512-898-2538
Mailing Address - Fax:
Practice Address - Street 1:300 N MAIN ST
Practice Address - Street 2:
Practice Address - City:THORNDALE
Practice Address - State:TX
Practice Address - Zip Code:76577-0200
Practice Address - Country:US
Practice Address - Phone:512-898-2538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid