Provider Demographics
NPI:1003833013
Name:ASCENSION SETON
Entity Type:Organization
Organization Name:ASCENSION SETON
Other - Org Name:ASCENSION SETON HIGHLAND LAKES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-324-1000
Mailing Address - Street 1:1345 PHILOMENA DRIVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3185
Mailing Address - Country:US
Mailing Address - Phone:512-324-1000
Mailing Address - Fax:512-459-5629
Practice Address - Street 1:3201 S WATER ST
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-4510
Practice Address - Country:US
Practice Address - Phone:512-715-3000
Practice Address - Fax:512-756-6405
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION SETON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-16
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000559261QA1903X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094151004Medicaid
TX094151004Medicaid