Provider Demographics
NPI:1427506914
Name:GORMAN INDEPENDENT SCHOOL DISTRICT
Entity type:Organization
Organization Name:GORMAN INDEPENDENT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:TREADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-734-3171
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:GORMAN
Mailing Address - State:TX
Mailing Address - Zip Code:76454-0008
Mailing Address - Country:US
Mailing Address - Phone:254-734-3171
Mailing Address - Fax:
Practice Address - Street 1:114 WEST LEXINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:GORMAN
Practice Address - State:TX
Practice Address - Zip Code:76454-0008
Practice Address - Country:US
Practice Address - Phone:254-734-3171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid