Organization
PROVIDENCE HEALTH ALLIANCE
Active
Other names
Ascension Medical Group Providence Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
CLAYTON CARSNER (VP/COO)
(512) 324-5846
Entity
Organization
Contact information
Practice address
1130 N LOOP 340, LACY LAKEVIEW, TX 76705
(254) 870-6500
Mailing address
1345 PHILOMENA ST, STE 410.3, AUSTIN, TX 78723
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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