Provider Demographics
NPI:1932634995
Name:JAYTON-GIRAND
Entity Type:Organization
Organization Name:JAYTON-GIRAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRIG
Authorized Official - Middle Name:
Authorized Official - Last Name:OVERBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-237-2991
Mailing Address - Street 1:PO BOX 168
Mailing Address - Street 2:
Mailing Address - City:JAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:79528-0168
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 MADISON
Practice Address - Street 2:
Practice Address - City:JAYTON
Practice Address - State:TX
Practice Address - Zip Code:79528-0168
Practice Address - Country:US
Practice Address - Phone:806-237-2991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid