Provider Demographics
NPI:1609917715
Name:UVALDE CONSOLIDATED INDEPENDENT SCHOOL DISTRICT
Entity Type:Organization
Organization Name:UVALDE CONSOLIDATED INDEPENDENT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF BUSINESS
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-278-6655
Mailing Address - Street 1:1001 N. GETTY STREET
Mailing Address - Street 2:P. O. BOX 1909
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78802-1906
Mailing Address - Country:US
Mailing Address - Phone:830-278-6655
Mailing Address - Fax:830-591-4931
Practice Address - Street 1:1000 N GETTY ST
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-4206
Practice Address - Country:US
Practice Address - Phone:830-278-6655
Practice Address - Fax:830-591-4931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid