Provider Demographics
NPI:1700392602
Name:ASCENSION SETON
Entity Type:Organization
Organization Name:ASCENSION SETON
Other - Org Name:ASCENSION SETON BASTROP HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-324-1000
Mailing Address - Street 1:1345 PHILOMENA ST
Mailing Address - Street 2:362
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723
Mailing Address - Country:US
Mailing Address - Phone:512-324-1000
Mailing Address - Fax:
Practice Address - Street 1:630 HIGHWAY 71 W STE E
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-4234
Practice Address - Country:US
Practice Address - Phone:512-304-0313
Practice Address - Fax:512-304-0326
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION SETON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-14
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health