Provider Demographics
NPI:1417498205
Name:SETON FAMILY OF DOCTORS
Entity Type:Organization
Organization Name:SETON FAMILY OF DOCTORS
Other - Org Name:SETON DIABETES AND MEDICAL NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP / COO
Authorized Official - Prefix:
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-324-5846
Mailing Address - Street 1:1345 PHILOMENA ST
Mailing Address - Street 2:SUITE 410.3
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5555 N LAMAR BLVD
Practice Address - Street 2:SUITE D125
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-1073
Practice Address - Country:US
Practice Address - Phone:512-324-1891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SETON FAMILY OF DOCTORS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-14
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty