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Organization
MOULTON ISD
Active
Organization
MOULTON ISD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE LUKSOVSKY (BUSINESS MANAGER)
(361) 596-4609
Entity
Organization
Contact information
Practice address
400 BOBKAT DR, MOULTON, TX 77975
(361) 596-4609
(361) 596-7578
Mailing address
PO BOX C, 400 BOBKAT DR, MOULTON, TX 77975-0070
(361) 596-4609
(361) 596-7578
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
—
—
163WS0200X
School Registered Nurse
—
—
164X00000X
Licensed Vocational Nurse
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
02/26/2007
Last updated
10/05/2007
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