Provider Demographics
NPI:1851653745
Name:MILFORD ISD
Entity Type:Organization
Organization Name:MILFORD ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-493-2911
Mailing Address - Street 1:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76670-0545
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 3RD AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:TX
Practice Address - Zip Code:76670-0545
Practice Address - Country:US
Practice Address - Phone:972-493-2911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid