Provider Demographics
NPI:1649488065
Name:SHELBYVILLE INDEPENDENT SCHOOL DISTRICT
Entity type:Organization
Organization Name:SHELBYVILLE INDEPENDENT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, SPECIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUVON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-598-2641
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75973-0325
Mailing Address - Country:US
Mailing Address - Phone:936-598-2641
Mailing Address - Fax:936-598-6842
Practice Address - Street 1:343 FM 417 W
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TX
Practice Address - Zip Code:75973-0325
Practice Address - Country:US
Practice Address - Phone:936-598-2641
Practice Address - Fax:936-598-6842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid