Provider Demographics
NPI:1265459242
Name:ASCENSION SETON
Entity Type:Organization
Organization Name:ASCENSION SETON
Other - Org Name:ASCENSION SETON MARBLE FALLS HEALTH CENTER
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:PO BOX 204229
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-4229
Mailing Address - Country:US
Mailing Address - Phone:512-715-3360
Mailing Address - Fax:512-715-3371
Practice Address - Street 1:1800 MORMON MILL RD
Practice Address - Street 2:BLDG B
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-4175
Practice Address - Country:US
Practice Address - Phone:830-693-2600
Practice Address - Fax:830-693-9755
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION SETON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-16
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164170601Medicaid
TX164170601Medicaid