NPIMap

Organization Active NPI

Austin Regional Clinic, PA

  • Durable Medical Equipment & Medical Supplies
  • Liberty Hill, TX
National Provider Identifier
1477213544
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
AUSTIN REGIONAL CLINIC, PA
Practice address
12779 West SH 29
Liberty Hill, TX 78642
Phone
(512) 778-7003
Fax
(512) 406-7317
NPI assigned
Dec 30, 2021
Last updated
Dec 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anas Daghestani, MD
Title
Ceo
Phone
(512) 419-0707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

12779 West SH 29
Liberty Hill, TX 78642

Mailing address

6210 E US Hwy 290
Suite 240 - Credentialing
Austin, TX 78723-1098
Phone (512) 338-3802

Other identifiers 1

IdentifierTypeStateIssuer
1333940-07MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Austin Regional Clinic9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640822400000",
    "number": "1477213544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E US HWY 290",
            "address_2": "SUITE 240 - CREDENTIALING",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231098",
            "telephone_number": "512-338-3802",
            "fax_number": "512-406-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12779 WEST SH 29",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "78642",
            "telephone_number": "512-778-7003",
            "fax_number": "512-406-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN REGIONAL CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "DAGHESTANI",
        "authorized_official_first_name": "ANAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-419-0707",
        "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": []
}

Other providers in Liberty Hill, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.