Provider Demographics
NPI:1396173951
Name:WALCOTT ISD
Entity type:Organization
Organization Name:WALCOTT ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LESLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARFSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-289-5222
Mailing Address - Street 1:4275 HIGHWAY 214
Mailing Address - Street 2:
Mailing Address - City:HEREFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79045-7705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4275 HIGHWAY 214
Practice Address - Street 2:
Practice Address - City:HEREFORD
Practice Address - State:TX
Practice Address - Zip Code:79045-7705
Practice Address - Country:US
Practice Address - Phone:806-289-5222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid