Provider Demographics
NPI:1396453510
Name:LA JOYA INDEPENDENT SCHOOL DISTRICT
Entity type:Organization
Organization Name:LA JOYA INDEPENDENT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:MARCO
Authorized Official - Last Name:BENAVIDES
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:956-827-1148
Mailing Address - Street 1:1909 SEAGULL LN
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4884
Mailing Address - Country:US
Mailing Address - Phone:956-827-1148
Mailing Address - Fax:
Practice Address - Street 1:201 E EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:LA JOYA
Practice Address - State:TX
Practice Address - Zip Code:78560-4001
Practice Address - Country:US
Practice Address - Phone:956-323-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)