| Organization Name: | MOULTON ISD |
| NPI Number: | 1639205644 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANGIE LUKSOVSKY (BUSINESS MANAGER) |
| Mailing Address: | 400 Bobkat Dr Moulton |
| State: | TX US |
| Postal Code: | 77975 |
| Phone Number: | 3615964609 |
| Fax Number: | 3615967578 |
| NPI Enumeration Date: | 02/26/2007 |
| NPI Last Update Date: | 10/05/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |