Providence Health Alliance

NPI #1932210838 in Waco, Texas

Provider Information

NPI Number: 1932210838
Entity Type: Organization
Organization Name: Providence Health Alliance
Primary Specialty: Specialist
Enumeration Date: Aug 31, 2006
Last Updated: Aug 31, 2023

Practice Location

Address: 6901 MEDICAL PKWY
City: Waco
State: Texas
ZIP Code: 76712-7910
Phone: (254) 751-4061

Authorized Official

Name: CLAYTON CARSNER
Title: VP/COO
Phone: (512) 324-5846

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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