Healthcare Provider Details

I. General information

NPI: 1235234576
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: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S COLORADO ST SUITES A-D
LOCKHART TX
78644-2707
US

IV. Provider business mailing address

1345 PHILOMENA ST.
AUSTIN TX
78723-3185
US

V. Phone/Fax

Practice location:
  • Phone: 512-376-9690
  • 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: MR. CRAIG CORDOLA
Title or Position: CFO
Credential:
Phone: 512-324-1000