Provider Demographics
NPI:1427310036
Name:MIDLOTHIAN ISD
Entity type:Organization
Organization Name:MIDLOTHIAN ISD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF SPECIAL ED
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-775-8296
Mailing Address - Street 1:100 WALTER STEPHENSON RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-3418
Mailing Address - Country:US
Mailing Address - Phone:972-775-8296
Mailing Address - Fax:972-775-1757
Practice Address - Street 1:100 WALTER STEPHENSON RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-3418
Practice Address - Country:US
Practice Address - Phone:972-775-8296
Practice Address - Fax:972-775-1757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-10
Last Update Date:2012-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid