Provider Demographics
NPI:1417192519
Name:SETON FAMILY OF HOSPITALS
Entity Type:Organization
Organization Name:SETON FAMILY OF HOSPITALS
Other - Org Name:LULING CRNA GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-324-1981
Mailing Address - Street 1:PO BOX 33034
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78265-3034
Mailing Address - Country:US
Mailing Address - Phone:830-875-7000
Mailing Address - Fax:830-875-7064
Practice Address - Street 1:130 HAYS ST
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:TX
Practice Address - Zip Code:78648-3207
Practice Address - Country:US
Practice Address - Phone:830-875-7000
Practice Address - Fax:830-875-7064
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SETON FAMILY OF HOSPITALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-04
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00779KMedicare UPIN