Provider Demographics
NPI:1871719658
Name:ROOSEVELT INDEPENDENT SCHOOL DISTRICT
Entity type:Organization
Organization Name:ROOSEVELT INDEPENDENT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-828-6595
Mailing Address - Street 1:1406 COUNTY ROAD 3300
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79403-7614
Mailing Address - Country:US
Mailing Address - Phone:806-842-3282
Mailing Address - Fax:806-842-3266
Practice Address - Street 1:1406 COUNTY ROAD 3300
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79403-7614
Practice Address - Country:US
Practice Address - Phone:806-842-3282
Practice Address - Fax:806-842-3266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)