Provider Demographics
NPI:1427708205
Name:STRATEGIC DEVELOPMENT & INSTRUCTION
Entity type:Organization
Organization Name:STRATEGIC DEVELOPMENT & INSTRUCTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-264-5293
Mailing Address - Street 1:16770 IMPERIAL VALLEY DR STE 151D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3449
Mailing Address - Country:US
Mailing Address - Phone:832-264-5293
Mailing Address - Fax:
Practice Address - Street 1:16770 IMPERIAL VALLEY DR STE 151D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3449
Practice Address - Country:US
Practice Address - Phone:832-264-5293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STRATEGIC DEVELOPMENT AND INSTRUCTION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1306494687Medicaid