Provider Demographics
NPI:1578904470
Name:SETON MEDICAL CENTER AUSTIN
Entity Type:Organization
Organization Name:SETON MEDICAL CENTER AUSTIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRITICAL CARE NP
Authorized Official - Prefix:
Authorized Official - First Name:JUANNA
Authorized Official - Middle Name:RUDSTON
Authorized Official - Last Name:HUSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, ACNP
Authorized Official - Phone:810-444-8510
Mailing Address - Street 1:1201 W 38TH ST
Mailing Address - Street 2:ICU APN OFFICE, 1ST FLOOR ICU
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1006
Mailing Address - Country:US
Mailing Address - Phone:512-324-1000
Mailing Address - Fax:
Practice Address - Street 1:1201 W 38TH ST
Practice Address - Street 2:ICU
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1006
Practice Address - Country:US
Practice Address - Phone:512-324-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX777844282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital