Provider Demographics
NPI:1609262716
Name:LLANO ISD
Entity Type:Organization
Organization Name:LLANO ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OD SPED
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:UTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-247-4747
Mailing Address - Street 1:1400 OATMAN ST
Mailing Address - Street 2:
Mailing Address - City:LLANO
Mailing Address - State:TX
Mailing Address - Zip Code:78643-2734
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 OATMAN ST
Practice Address - Street 2:
Practice Address - City:LLANO
Practice Address - State:TX
Practice Address - Zip Code:78643-2734
Practice Address - Country:US
Practice Address - Phone:325-247-4747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150901Medicaid