# PROVIDENCE HEALTH SERVICES OF WACO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962505354
- **Authorized official:** MRS. KAREN K RICHARDSON (SENIOR VP, CFO)
- **Authorized official phone:** (254) 751-4146

## Contact information

- **Practice address:** 6901 MEDICAL PKWY, WACO, TX 76712-7910
- **Practice address phone:** (254) 751-4146
- **Practice address fax:** (254) 751-4283
- **Mailing address:** PO BOX 2589, WACO, TX 76702-2589
- **Mailing address phone:** (254) 751-4146
- **Mailing address fax:** (254) 751-4283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 02/01/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 111829101 | — | TX |