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Organization

AUSTIN REGIONAL CLINIC, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANAS DAGHESTANI MD (PRESIDENT/CEO)
(512) 419-0707
Entity
Organization

Contact information

Practice address
2100 AUTUMN SLATE DR STE 150, PFLUGERVILLE, TX 78660-6034
(737) 220-7200
(512) 406-7339
Mailing address
6210 E US HWY 290, SUITE 420 - CREDENTIALING, AUSTIN, TX 78723-1098
(512) 338-3802
(512) 406-6216

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1333940-03
TX
Enumeration date
07/10/2019
Last updated
07/10/2019
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