Healthcare Provider Details

I. General information

NPI: 1932330081
Provider Name (Legal Business Name): SETON FAMILY OF HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 01/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 KYLE PKWY
KYLE TX
78640-6112
US

IV. Provider business mailing address

6001 KYLE PKWY
KYLE TX
78640-6112
US

V. Phone/Fax

Practice location:
  • Phone: 512-504-5170
  • Fax: 512-268-8716
Mailing address:
  • Phone: 512-504-5170
  • Fax: 512-268-8716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number26504
License Number StateTX

VIII. Authorized Official

Name: JULIE HOLLY
Title or Position: REGIONAL DIRECTOR NET REV & REIMB
Credential:
Phone: 512-324-3269