Ascension Providence

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

14491 Issued in TX

Legal business name

ASCENSION PROVIDENCE

Doing business as

Ascension Providence Plaza Outpatient Pharmacy

Practice address

405 Londonderry Dr Ste 104
Waco, TX 76712-7920

Phone

(254) 751-4915

Fax

(254) 751-4916

NPI assigned

Feb 7, 2007

Last updated

Sep 16, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Julie L Holly

Title

Reg Dir Net Rev & Reimb

Phone

(210) 410-2789

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ascension Providence Plaza Outpatient Pharmacy Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Providence Depaul Ctr5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Ascension Providence

  dba Ascension Providence Salome Inpatient Rehabilitation Center

  • Rehabilitation Hospital Unit
  • Waco, TX
  • NPI 1497559140
  NPD tax ID
• Providence Health Services of Waco

  • Psychiatric Hospital
  • Waco, TX
  • NPI 1033436407
  NPD tax ID
• Providence Health Services of Waco

  dba Falls Community Health Center

  • Clinic/Center
  • Marlin, TX
  • NPI 1306872213
  NPD tax ID
• Providence Health Services of Waco

  • Ambulatory Surgical Clinic/Center
  • Waco, TX
  • NPI 1962505354
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1386784304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR STE 104",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127920",
            "telephone_number": "254-751-4915",
            "fax_number": "254-751-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR STE 104",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127920",
            "telephone_number": "254-751-4915",
            "fax_number": "254-751-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION PROVIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "HOLLY",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "REG DIR NET REV & REIMB",
        "authorized_official_telephone_number": "210-410-2789"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "14491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370017",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2099862",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Providence Plaza Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Awais Arshad
• Don Ray Arterburn, PHD LMFT
• Louanna G Arterburn, LPC
• Kristin M Arterbury, LPC ASSOCIATE
• Ascension Providence
• Ascension Providence (Ascension Providence Salome Inpatient Rehabilitation Center)
• Ascension Providence (Ascension Providence Depaul Center)
• Hannah Ashley, LCSW
• Ian Ashley, MD
• Christopher E Asikis, LMFT, LCDC

• Community/Retail Pharmacy in Waco, TX
• Providers in Waco, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.