Organization Active NPI

Austin Regional Clinic, PA

Doing business as ARC - Quarry Lake

  • Durable Medical Equipment & Medical Supplies
  • Austin, TX
National Provider Identifier
1710443205
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 - Quarry Lake
Practice address
4515 Seton Center Pkwy
Ste 220
Austin, TX 78759-5784
Phone
(512) 338-8388
Fax
(512) 406-6274
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) 231-5594

Specialties & licenses 1

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

Addresses

Primary practice location

4515 Seton Center Pkwy
Ste 220
Austin, TX 78759-5784

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1333940-03MedicaidTX

Other names 1

  • ARC - Quarry Lake Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1050241Austin Regional Clinic at Quarry Lake4515 Seton Center Parkway Suite 220, Austin, TX 78759AccreditationJan 24, 2028

National Provider Directory

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": "1710443205",
    "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": "4515 SETON CENTER PKWY",
            "address_2": "STE 220",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595784",
            "telephone_number": "512-338-8388",
            "fax_number": "512-406-6274"
        }
    ],
    "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": "512-231-5594",
        "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": "1333940-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ARC - Quarry Lake",
            "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.

Verify at the official NPI Registry.