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Organization

AUSTIN REGIONAL CLINIC, PA

Active
Other names
ARC - Quarry Lake
Organization subpart
No

Provider details

NPI number
Authorized official
ANAS DAGHESTANI MD (CEO/PRESIDENT)
(512) 231-5594
Entity
Organization

Contact information

Practice address
4515 SETON CENTER PKWY, STE 220, AUSTIN, TX 78759-5784
(512) 338-8388
(512) 406-6274
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
02/20/2019
Last updated
02/20/2019
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