Provider Demographics
NPI:1679787642
Name:ASCENSION SETON
Entity Type:Organization
Organization Name:ASCENSION SETON
Other - Org Name:DELL CHILDREN'S MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL DIRECTOR NET REV & REIMB
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-324-3269
Mailing Address - Street 1:4900 MUELLER BLVD # 4C.024
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3079
Mailing Address - Country:US
Mailing Address - Phone:512-324-0149
Mailing Address - Fax:512-324-0756
Practice Address - Street 1:4900 MUELLER BLVD # 4C024
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3079
Practice Address - Country:US
Practice Address - Phone:512-324-0149
Practice Address - Fax:512-324-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
TX255433336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX25543OtherBOARD OF PHARMACY LICENSE