Organization
SETON HEALTHCARE
Active
Other names
Trauma Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM THOMAS (CHIEF ORGANIZATION OFFICER)
(512) 324-8960
Entity
Organization
Contact information
Practice address
601 E 15TH ST, AUSTIN, TX 78701-1930
(512) 324-8960
(512) 324-8962
Mailing address
PO BOX 65118, SAN ANTONIO, TX 78265-5118
(512) 324-8960
(512) 324-8962
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
207P00000X
Emergency Medicine Physician
—
—
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
—
208000000X
Pediatrics Physician
—
—
208200000X
Plastic Surgery Physician
—
—
2086S0102X
Surgical Critical Care Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
2086S0127X
Trauma Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081299201
—
TX
05
—
081344602
—
TX
Enumeration date
07/03/2006
Last updated
07/28/2009
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