# AUSTIN REGIONAL CLINIC, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346994373
- **Authorized official:** ANAS DAGHESTANI MD (CEO)
- **Authorized official phone:** (512) 419-0707

## Contact information

- **Practice address:** 622 W STATE HWY 71, STE 102, BASTROP, TX 78602-4234
- **Practice address phone:** (512) 308-4311
- **Practice address fax:** (512) 406-7397
- **Mailing address:** 6210 E US HWY 290, SUITE 240 - CREDENTIALING, AUSTIN, TX 78723-1098
- **Mailing address phone:** (512) 338-3802
- **Mailing address fax:** (512) 406-6212

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 02/08/2022
- **Last updated:** 02/08/2022