Healthcare Provider Details

I. General information

NPI: 1124137054
Provider Name (Legal Business Name): ASCENSION SETON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11113 RESEARCH
AUSTIN TX
78759-5236
US

IV. Provider business mailing address

1345 PHILOMENA ST.
AUSTIN TX
78723-3185
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-6000
  • 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 TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number007976
License Number StateTX

VIII. Authorized Official

Name: MR. CRAIG CORDOLA
Title or Position: PRESIDENT & CEO
Credential:
Phone: 512-324-1000