THE AUSTIN DIAGNOSTIC CLINIC, PLLC (NPI# 1003259763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003259763 |
| Entity Type | Organization |
| Organization Name | THE AUSTIN DIAGNOSTIC CLINIC, PLLC |
| Practice Address |
12221 N Mopac Expy Austin TX 78758 |
| Mailing Address |
2000 Health Park Dr Brentwood TN 37027-4525 |
| Practice Telephone | 5129011111 |
| Practice Fax Number | 5129013945 |
| Mailing Telephone | 6153725004 |
| Mailing Fax Number | 8668314898 |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2018-06-25 |
| Authorized Official Name | JOHN REBOK (VICE PRESIDENT) |
| Authorized Official Telephone | 6153725004 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246RP1900X |
Technician, Pathology Specialization: Phlebotomy |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932186640 | The Austin Diagnostic Clinic, Pllc | Nurse Practitioner | 12221 N. Mo Pac Expy, Dept of Endocrinology, Austin, TX 78758 | 2005-12-23 |
| 1104803816 | The Austin Diagnostic Clinic, Pllc | Internal Medicine | 12221 Mo Pac Expwy North, Dept of Cardiology, Austin, TX 78758 | 2005-12-23 |
| 1407839129 | The Austin Diagnostic Clinic, Pllc | Allergy & Immunology | 12221 N Mo Pac Expwy, Dept of Allergy, Austin, TX 78758 | 2005-11-28 |
| 1669447926 | The Austin Diagnostic Clinic, Pllc | Surgery | 12221 Mopac Expressway North, Dept of Surgery, Austin, TX 78758 | 2006-02-21 |
| 1740255926 | The Austin Diagnostic Clinic, Pllc | Urology | 12221 Mo Pac Expwy North, Dept of Urology, Austin, TX 78758 | 2006-02-21 |
| 1386619641 | The Austin Diagnostic Clinic, Pllc | Internal Medicine | 12221 Mopac Expressway North, Dept of Pulmonary Disease, Austin, TX 78758 | 2006-02-21 |
| 1003881368 | The Austin Diagnostic Clinic, Pllc | Internal Medicine | 12221 N Mo Pac Expy, Dept of Rheumatology, Austin, TX 78758 | 2006-02-21 |
| 1992770267 | The Austin Diagnostic Clinic, Pllc | Podiatrist | 12221 Mopac Expressway North, Dept of Podiatry, Austin, TX 78758 | 2006-02-21 |
| 1467426205 | The Austin Diagnostic Clinic, Pllc | Nurse Practitioner | 2400 Cedar Bend Dr, Dept of Pediatrics, Austin, TX 78758 | 2006-02-16 |
| 1578537536 | The Austin Diagnostic Clinic, Pllc | Physical Medicine & Rehabilitation | 12221 Mopac Expressway N, Dept of Physical Medicine, Austin, TX 78758 | 2006-02-15 |
| Street Address |
12221 N MOPAC EXPY |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245238534 | Malik M Merchant | Internal Medicine | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2005-07-11 |
| 1477151413 | Jessica C. Heim | Registered Nurse | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2020-10-13 |
| 1639786387 | Renee Yvonne Vilaire | Registered Nurse | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2020-09-28 |
| 1376150052 | Kimberly Marie Labinsky | Registered Nurse | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2020-09-28 |
| 1912515123 | Renee Hyder | Nurse Practitioner | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2020-07-14 |
| 1255963468 | Melanie Marie Vague | Registered Nurse | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2020-02-05 |
| 1730728684 | Sally Anne Jung | Registered Nurse | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2019-12-24 |
| 1831735505 | Sadie Christine Laddusaw | Anesthesiologist Assistant | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2019-11-18 |
| 1003386285 | Lauren Van Orden | Speech-Language Pathologist | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2018-11-29 |
| 1114406246 | Sarah Mcbride | Clinical Nurse Specialist | 12221 N Mopac Expy, Austin, TX 78758 | 2018-08-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1083243661 | Donna Bella Laurel Portillo | Pharmacist | 12221 N Mopac Expwy, Austin, TX 78758 | 2020-04-05 |
| 1881249092 | Elizabeth Logan Anderson | Behavioral Analyst | 2100 Kramer Ln., Suite 150, Austin, TX 78758 | 2019-08-05 |
| 1295388502 | Bridget Sue Morgan | Behavioral Analyst | 2100 Kramer Ln #150, Austin, TX 78758 | 2019-07-17 |
| 1508326885 | Jonathan James Runnels | Anesthesiologist Assistant | 12221n Mopac, Austin, TX 78758 | 2019-03-22 |
| 1427527324 | Nayely Gutierrez | Dietitian, Registered | 8606 Delaware Ct, Austin, TX 78758 | 2018-11-20 |
| 1720569635 | Shari Wright | Licensed Vocational Nurse | 12349 Metric Blvs # 425, Austin, TX 78758 | 2018-08-28 |
| 1528545456 | Alexis N Bongiorno | Registered Nurse | 11901 Hobby Horse Court, 1516, Austin, TX 78758 | 2018-07-24 |
| 1679072573 | Lori Scott | Counselor | 1600 Payton Gin Road, Austin, TX 78758 | 2018-02-06 |
| 1003322488 | Lisa Robyn Lee | Behavior Technician | 2018 W Rundberg Ln, #13d, Austin, TX 78758 | 2017-12-20 |
| Find all providers in zip 78758 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831431766 | Max Michael Wells | Pathology | 3608 Woodcutters Way, Austin, TX 78746-1541 | 2013-03-18 |
| 1538445937 | Thyroid Cytopathology Partners Pa | Pathology | 12357 A Riata Trace Parkway, Bldg. 5, Suite 100, Austin, TX 78727 | 2011-10-30 |
| 1164488912 | Ann Riopel White | Pathology | 3445 Executive Center Drive, Suite 250, Austin, TX 78731-1678 | 2006-04-21 |
| 1285695577 | Robert Emmet Connor | Pathology | 9200 Wall St, Austin, TX 78754-4534 | 2006-03-28 |
| 1922088756 | Mary E Vono | Pathology | 3445 Executive Center Dr Ste 250, Austin, TX 78731-1678 | 2006-01-18 |
| 1922080894 | Joseph Paul Pulcini | Pathology | 3445 Executive Center Dr, Suite 250, Austin, TX 78731-1678 | 2005-11-16 |
| 1477534535 | Heather Bonnie Rytting | Pathology | 3603 Bridle Path, Austin, TX 78703-2646 | 2005-11-07 |
| 1104807221 | Vilmos A Thomazy | Pathology | 12221 N Mopac Expressway, Namc Department of Pathology, Austin, TX 78756 | 2005-11-07 |
| 1386647022 | Leslie W Dalton IIi | Pathology | 901 W Ben White Blvd, Austin, TX 78704-6903 | 2005-05-26 |
| 1730574971 | Nkechi A Okonkwo | Pathology | 3445 Executive Center Dr, Ste 250, Austin, TX 78731-1678 | 2015-04-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.