Provider Demographics
NPI:1942795133
Name:ASCENSION SETON
Entity Type:Organization
Organization Name:ASCENSION SETON
Other - Org Name:ASCENSION SETON BASTROP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO ASCENSION TEXAS
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-324-1867
Mailing Address - Street 1:1345 PHILOMENA ST # 362
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3210
Mailing Address - Country:US
Mailing Address - Phone:512-237-3214
Mailing Address - Fax:512-380-7551
Practice Address - Street 1:630 HIGHWAY 71 W
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:512-324-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION SETON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-29
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital