# PROVIDENCE HEALTH ALLIANCE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ascension Texas Imaging
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063027464
- **Authorized official:** CLAYTON CARSNER (VP/COO)
- **Authorized official phone:** (512) 324-5846

## Contact information

- **Practice address:** 1130 N LOOP 340, WACO, TX 76705
- **Practice address phone:** (254) 537-6880
- **Practice address fax:** (254) 751-4859
- **Mailing address:** 1345 PHILOMENA ST, SUITE 410.3, AUSTIN, TX 78723
- **Mailing address phone:** (512) 324-5938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 09/11/2020
- **Last updated:** 09/11/2020