Organization
ASCENSION PROVIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG CORDOLA (CEO)
(512) 324-1000
Entity
Organization
Contact information
Practice address
6901 MEDICAL PKWY, WACO, TX 76712-7910
(254) 751-4146
(254) 751-4283
Mailing address
P.O. BOX 2589, WACO, TX 76702-2589
(254) 751-4146
(254) 751-4283
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
000040
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111829102
—
TX
05
—
112551001
—
TX
Enumeration date
08/29/2005
Last updated
03/05/2019
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