NPIMap

Organization Active NPI

Region III Education Service Center

  • Early Intervention Provider Agency
  • Victoria, TX
National Provider Identifier
1003981572
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
REGION III EDUCATION SERVICE CENTER
Practice address
1905 Leary LN
Victoria, TX 77901-2818
Phone
(361) 573-0731
Fax
(361) 573-1594
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angie Marie Bolom, OTRNPI 1831134774
Title
Coordinator of Therapy Services
Phone
(361) 573-0731

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

1905 Leary LN
Victoria, TX 77901-2818

Mailing address

1905 Leary LN
Victoria, TX 77901-2818
Phone (361) 573-0731

Other identifiers 1

IdentifierTypeStateIssuer
017427801MedicaidTX

National Provider Directory

National Provider Directory

Locations

1905 Leary Ln
Victoria, TX 77901
Phone (361) 573-0731

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1003981572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 LEARY LN",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012818",
            "telephone_number": "361-573-0731",
            "fax_number": "361-573-1594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 LEARY LN",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012818",
            "telephone_number": "361-573-0731",
            "fax_number": "361-573-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGION III EDUCATION SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "BOLOM",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "COORDINATOR OF THERAPY SERVICES",
        "authorized_official_telephone_number": "361-573-0731",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017427801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.