# EDUCATION SERVICE CENTER REGION XV

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396867966
- **Authorized official:** BRENDA MOELLER (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (325) 658-6571

## Contact information

- **Practice address:** 612 S IRENE ST, SAN ANGELO, TX 76903-6629
- **Practice address phone:** (325) 658-6571
- **Practice address fax:** (325) 653-0036
- **Mailing address:** PO BOX 5199, SAN ANGELO, TX 76902-5199
- **Mailing address phone:** (325) 658-6571
- **Mailing address fax:** (325) 653-0036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 04/04/2007
- **Last updated:** 09/11/2025