NPI 1063027464
Providence Health Alliance
Practice location
- Address
- 1130 N Loop 340, Waco, TX 76705
- Phone
- (254) 537-6880
- Fax
- (254) 751-4859
- Mailing address
- 1345 Philomena St Suite 410.3, Austin, TX 78723
Authorised official
- Name
- Clayton Carsner
- Title
- Vp/Coo
- Phone
- (512) 324-5846
Registered specialties
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
Registry record
- NPI
- 1063027464
- Entity type
- Organization
- NPI issued
- 11 Sep 2020
- Record last updated
- 11 Sep 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.