Organization
EDUCATION SERVICE CENTER REGION XV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA MOELLER (ADMINISTRATIVE ASSISTANT)
(325) 658-6571
Entity
Organization
Contact information
Practice address
612 S IRENE ST, SAN ANGELO, TX 76903-6629
(325) 658-6571
(325) 653-0036
Mailing address
PO BOX 5199, SAN ANGELO, TX 76902-5199
(325) 658-6571
(325) 653-0036
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
174400000X
Specialist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/04/2007
Last updated
09/11/2025
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