Provider Demographics
NPI:1982748646
Name:REGION 19 EDUCATION SERVICE CENTER
Entity type:Organization
Organization Name:REGION 19 EDUCATION SERVICE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DATA BILLING MANAGEMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BETANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-780-6564
Mailing Address - Street 1:6611 BOEING DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1010
Mailing Address - Country:US
Mailing Address - Phone:915-780-6576
Mailing Address - Fax:915-780-5303
Practice Address - Street 1:6611 BOEING DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1010
Practice Address - Country:US
Practice Address - Phone:915-780-6576
Practice Address - Fax:915-780-5303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017440101Medicaid