Provider Demographics
NPI:1821125121
Name:PFLUGERVILLE I.S.D.
Entity Type:Organization
Organization Name:PFLUGERVILLE I.S.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERRELL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-594-0053
Mailing Address - Street 1:1401 PECAN ST W
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2518
Mailing Address - Country:US
Mailing Address - Phone:512-594-0000
Mailing Address - Fax:512-594-0051
Practice Address - Street 1:1401 PECAN ST W
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2518
Practice Address - Country:US
Practice Address - Phone:512-594-0000
Practice Address - Fax:512-594-0051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
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