Healthcare Provider Details

I. General information

NPI: 1093810327
Provider Name (Legal Business Name): ASCENSION SETON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 RED RIVER ST
AUSTIN TX
78701-1918
US

IV. Provider business mailing address

1345 PHILOMENA DRIVE
AUSTIN TX
78723-3185
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number000335
License Number StateTX

VIII. Authorized Official

Name: JULIE HOLLY
Title or Position: REGIONAL DIR NET REV & REIMB
Credential:
Phone: 210-410-2789