Austin Diagnostic Clinic, PA
Organization Active NPI Hematology & Oncology Physician · Austin, TX
NPI 1104153592 · NPPES record last updated Nov 6, 2009
Key facts
- NPI
- 1104153592
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- Legal business name
- AUSTIN DIAGNOSTIC CLINIC, PA
- Practice address
- 12221 N Mo Pac Expy
Austin, TX 78758-2401 - Phone
- (512) 901-1111
- Fax
- (512) 901-3945
- NPI assigned
- Nov 6, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Robert Spurck Jr.
- Title
- Ceo
- Phone
- (512) 901-1111
Other NPIs on the same Medicare enrollment 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031112000236 | TX | Part B Supplier - Clinic/Group Practice | 1254244551 |
Receives reassigned benefits from 132 practitioners 24 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician |
207RH0003X | Yes |
Addresses
Primary practice location
12221 N Mo Pac Expy
Austin, TX 78758-2401
Mailing address
12221 N Mo Pac Expy
Austin, TX 78758-2401
Phone (512) 901-1111
Other names
- HEMATOLOGY/ONCOLOGY DEPARTMENT
Other providers in Austin, TX
- Austin Diagnostic Clinic
- Austin Diagnostic Clinic
- Austin Diagnostic Clinic
- Austin Diagnostic Clinic PA
- Austin Diagnostic Clinic, PA
- Austin Diagnostic Clinic, PA
- Austin Diagnostic Clinic, PA
- Austin Diagnostic Clinic, PA
- Austin Diagnostic Clinic, PA
- Austin Diagnostic Clinic, PA
All providers in Austin, TX · Hematology & Oncology Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.