Healthcare Provider Details

I. General information

NPI: 1972733376
Provider Name (Legal Business Name): SETON HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W 38TH ST
AUSTIN TX
78705-1000
US

IV. Provider business mailing address

1301 W 38TH ST
AUSTIN TX
78705-1000
US

V. Phone/Fax

Practice location:
  • Phone: 512-681-0456
  • Fax: 512-681-0501
Mailing address:
  • Phone: 512-681-0456
  • Fax: 512-681-0501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: CHARLES BARNETT
Title or Position: PRESIDENT/CEO
Credential:
Phone: 512-324-1923