Provider Demographics
NPI:1932479490
Name:MULLIN ISD
Entity Type:Organization
Organization Name:MULLIN ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MICKELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-985-3374
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:MULLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76864-0128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:403 WEST BULLDOG DRIVE
Practice Address - Street 2:
Practice Address - City:MULLIN
Practice Address - State:TX
Practice Address - Zip Code:76864-0000
Practice Address - Country:US
Practice Address - Phone:325-985-3374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid