Organization
PROVIDENCE HEALTH ALLIANCE
Active
Organization
PROVIDENCE HEALTH ALLIANCE
Active
Other names
Ascension Texas Imaging
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, WACO, TX 76705
(254) 537-6880
(254) 751-4859
Mailing address
1345 PHILOMENA ST, SUITE 410.3, AUSTIN, TX 78723
(512) 324-5938
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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