Healthcare Provider Details

I. General information

NPI: 1437714987
Provider Name (Legal Business Name): ASCENSION SETON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ROY RIVERS RD
ELGIN TX
78621
US

IV. Provider business mailing address

PO BOX 16144
BELFAST ME
04915-4056
US

V. Phone/Fax

Practice location:
  • Phone: 512-237-5777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE HOLLY
Title or Position: REG DIR NET REV AND REIMB
Credential:
Phone: 512-324-3269