Active NPI
Austin Regional Clinic, PA
- Durable Medical Equipment & Medical Supplies
- Austin, TX
National Provider Identifier
1124323845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- AUSTIN REGIONAL CLINIC, PA
- Practice address
- 3828 S. 1St St
Austin, TX 78704-7048 - Phone
- (512) 443-1311
- Fax
- (512) 406-6266
- NPI assigned
- Jan 12, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anas Daghestani, MD
- Title
- Ceo/President
- Phone
- (512) 231-5500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
3828 S. 1St St
Austin, TX 78704-7048
Mailing address
6210 E US Hwy 290
Suite 420 - Credentialing
Austin, TX 78723-1098
Phone (512) 338-3802
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1333940-03 | Medicaid | TX |
Other names 1
- ARC - South 1st
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0504721 | Austin Regional Clinic South | Accreditation | Jan 24, 2028 |
National Provider Directory
National Provider DirectoryMember organizations 4
Organizations listed as members of this organization in the National Provider Directory.
-
- Community Based Hospice Care Agency
- Austin, TX
- NPI 1629435417
Member Of
Locations
3828 S 1st St
Austin, TX 78704
Phone (512) 443-1311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294790400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1550620800000",
"number": "1124323845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6210 E US HWY 290",
"address_2": "SUITE 420 - CREDENTIALING",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787231098",
"telephone_number": "512-338-3802",
"fax_number": "512-406-6216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3828 S. 1ST ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787047048",
"telephone_number": "512-443-1311",
"fax_number": "512-406-6266"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AUSTIN REGIONAL CLINIC, PA",
"organizational_subpart": "NO",
"enumeration_date": "2011-01-12",
"last_updated": "2019-02-20",
"status": "A",
"authorized_official_last_name": "DAGHESTANI",
"authorized_official_first_name": "ANAS",
"authorized_official_title_or_position": "CEO/PRESIDENT",
"authorized_official_telephone_number": "512-231-5500",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1333940-03",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ARC - South 1st",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.