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General NPI Number Information
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NPI Number | 1356682298
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Entity Type | Organization
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Legal Business Name | ASCENSION SETON
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Dates
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Enumeration Date | 03/01/2013
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 130 HAYS ST STE B
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City | LULING
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State | TX
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Zip | 78648-3207
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Country | US
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Telephone | 830-875-7078
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Fax |
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Provider Business Mailing Address
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Address Line | 130 HAYS ST STE B
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City | LULING
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State | TX
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Zip | 78648-3207
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Country | US
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Telephone | 830-875-7078
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | CRAIG CORDOLA
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Credential |
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Telephone | 512-324-1981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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