Organization
AUSTIN DIAGNOSTIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN M ANDREW (CREDENTIALING SPECIALIST)
(512) 901-4937
Entity
Organization
Contact information
Practice address
7600 N CAPITAL OF TEXAS HWY, AMBULATORY SURGERY CENTER, AUSTIN, TX 78731-1181
(512) 901-4029
(512) 901-3920
Mailing address
12221 MO PAC EXPWY N, AMBULATORY SURGERY CENTER, AUSTIN, TX 78758-2483
(512) 901-4029
(512) 901-3920
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
008167
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140347948
—
TX
Enumeration date
05/26/2006
Last updated
10/21/2009
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