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General NPI Number Information
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NPI Number | 1497559140
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Entity Type | Organization
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Legal Business Name | ASCENSION PROVIDENCE
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 6901 MEDICAL PARKWAY 4 EAST TOWER
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City | WACO
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State | TX
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Zip | 76712
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Country | US
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Telephone | 254-751-4482
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2589
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City | WACO
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State | TX
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Zip | 76702-2589
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRSIDENT
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Name | PHILIP PATTERSON
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Credential |
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Telephone | 254-751-4482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State |
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