Provider Demographics
NPI:1760604110
Name:BOYS & GIRLS CLUBS OF SOUTH CENTRAL TEXAS
Entity Type:Organization
Organization Name:BOYS & GIRLS CLUBS OF SOUTH CENTRAL TEXAS
Other - Org Name:TEXAS PREPARATORY SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-805-3000
Mailing Address - Street 1:PO BOX 1643
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78667
Mailing Address - Country:US
Mailing Address - Phone:512-805-3000
Mailing Address - Fax:512-805-7739
Practice Address - Street 1:900 BUGG LANE STE 110 A
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666
Practice Address - Country:US
Practice Address - Phone:512-805-3000
Practice Address - Fax:512-805-7739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)