Provider Demographics
NPI:1639697949
Name:ASCENSION SETON
Entity Type:Organization
Organization Name:ASCENSION SETON
Other - Org Name:ASCENSION SETON LOCKHART FAMILY HEALTH CENTER AT SOUTH COMMERCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-324-1867
Mailing Address - Street 1:300 S COMMERCE ST STE B
Mailing Address - Street 2:
Mailing Address - City:LOCKHART
Mailing Address - State:TX
Mailing Address - Zip Code:78644-2887
Mailing Address - Country:US
Mailing Address - Phone:512-398-2331
Mailing Address - Fax:512-398-9602
Practice Address - Street 1:300 S COMMERCE ST
Practice Address - Street 2:STE B
Practice Address - City:LOCKHART
Practice Address - State:TX
Practice Address - Zip Code:78644-2887
Practice Address - Country:US
Practice Address - Phone:512-398-2331
Practice Address - Fax:512-398-9602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health