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Organization
THE AUSTIN DIAGNOSTIC CLINIC, PLLC
Active
Organization
THE AUSTIN DIAGNOSTIC CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN REBOK (VICE PRESIDENT)
(615) 372-5004
Entity
Organization
Contact information
Practice address
12221 N. MO PAC EXPY, DEPT OF ENDOCRINOLOGY, AUSTIN, TX 78758
(512) 901-4005
(512) 901-3905
Mailing address
2000 HEALTH PARK DR DEPT OF, BRENTWOOD, TN 37027-4525
(615) 372-5004
(866) 831-4898
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140347921
—
TX
Enumeration date
12/23/2005
Last updated
06/25/2018
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