Organization Active NPI

Austin Regional Clinic, PA

Doing business as ARC - Manor

  • Durable Medical Equipment & Medical Supplies
  • Manor, TX
National Provider Identifier
1295291789
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
AUSTIN REGIONAL CLINIC, PA
Doing business as
ARC - Manor
Practice address
11300 E Hwy 390
BLDG 2, Ste 230
Manor, TX 78653-0397
Phone
(512) 582-6075
Fax
(512) 406-6275
NPI assigned
Feb 20, 2019
Last updated
Feb 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

11300 E Hwy 390
BLDG 2, Ste 230
Manor, TX 78653-0397

Mailing address

6210 E US Hwy 290
Suite 420 - Credentialing
Austin, TX 78723-1098
Phone (512) 338-3802

Other identifiers 1

IdentifierTypeStateIssuer
1333940-07MedicaidTX

Other names 1

  • ARC - Manor Doing business as

National Provider Directory

National Provider Directory

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1295291789",
    "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": "11300 E HWY 390",
            "address_2": "BLDG 2, STE 230",
            "city": "MANOR",
            "state": "TX",
            "postal_code": "786530397",
            "telephone_number": "512-582-6075",
            "fax_number": "512-406-6275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN REGIONAL CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-20",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1333940-07",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ARC - Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manor, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.