Organization
AUSTIN REGIONAL CLINIC, PA
Active
Other names
ARC - Manor
Organization subpart
No
Provider details
NPI number
Authorized official
ANAS DAGHESTANI MD (CEO/PRESIDENT)
(512) 231-5500
Entity
Organization
Contact information
Practice address
11300 E HWY 390, BLDG 2, STE 230, MANOR, TX 78653-0397
(512) 582-6075
(512) 406-6275
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
—
1333940-07
—
TX
Enumeration date
02/20/2019
Last updated
02/20/2019
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