Organization
PROVIDENCE HEALTH SERVICES OF WACO
Active
Other names
Providence Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN K RICHARDSON (SENIOR VP, CFO)
(254) 751-4146
Entity
Organization
Contact information
Practice address
6901 MEDICAL PKWY, WACO, TX 76712-7910
(254) 751-4146
(254) 751-4283
Mailing address
PO BOX 2589, WACO, TX 76702-2589
(254) 751-4146
(254) 751-4283
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111829101
—
TX
Enumeration date
09/07/2006
Last updated
02/01/2012
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