Organization
AUSTIN REGIONAL CLINIC, PA
Active
Other names
ARC - Georgetown
Organization subpart
No
Provider details
NPI number
Authorized official
ANAS DAGHESTANI MD (CEO/PRESIDENT)
(512) 419-0707
Entity
Organization
Contact information
Practice address
940 W UNIVERSITY AVE, SUITE 101, GEORGETOWN, TX 78626-6503
(512) 819-0264
(512) 406-6242
Mailing address
6210 E US HWY 290, SUITE 420 - CREDENTIALING, AUSTIN, TX 78723-1098
(512) 338-3802
(512) 406-6212
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
03/18/2020
Last updated
03/18/2020
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