AUSTIN DIAGNOSTIC CLINIC, PA (NPI# 1104153592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104153592 |
Entity Type | Organization |
Organization Name | AUSTIN DIAGNOSTIC CLINIC, PA |
Other Organization Name | HEMATOLOGY/ONCOLOGY DEPARTMENT |
Practice Address |
12221 N Mo Pac Expy Austin TX 78758-2401 |
Practice Telephone | 5129011111 |
Practice Fax Number | 5129013945 |
Mailing Telephone | 5129011111 |
Mailing Fax Number | 5129013945 |
Enumeration Date | 2009-11-06 |
Last Update Date | 2009-11-06 |
Authorized Official Name | MR. ROBERT SPURCK JR. (CEO) |
Authorized Official Telephone | 5129011111 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
HEMATOLOGY/ONCOLOGY DEPARTMENT | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619923950 | Austin Diagnostic Clinic, Pa | Clinic/Center | 7600 N Capital of Texas Hwy, Ambulatory Surgery Center, Austin, TX 78731-1181 | 2006-05-26 |
1922231810 | Austin Diagnostic Clinic, Pa | Optometrist | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2009-08-26 |
1194790451 | Austin Diagnostic Clinic, Pa | Radiologic Technologist | 12221 Mopac Expressway North, Dept of Imaging Services, Austin, TX 78758-2483 | 2006-02-21 |
1588638548 | Austin Diagnostic Clinic, Pa | Orthopaedic Surgery | 12221 Mopac Expressway N, Dept of Orthopaedic Surgery, Austin, TX 78758-2483 | 2006-02-15 |
1013981182 | Austin Diagnostic Clinic, Pa | Occupational Therapist | 12221 Mo Pac Expwy North, Dept of Physical Therapy, Austin, TX 78758-2483 | 2006-02-15 |
1487632618 | Austin Diagnostic Clinic, Pa | Physician Assistant | 12221 N Mo Pac Expy, Dept of Hematology/oncology, Austin, TX 78758-2483 | 2006-01-06 |
Street Address |
12221 N MO PAC EXPY |
City | AUSTIN |
State | TX |
Zip Code | 78758-2401 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083618706 | Joy Nielsen | Urology | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2005-06-10 |
1790129161 | Amanda R Morstad | Internal Medicine | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2013-04-29 |
1528325586 | Matthew Richard Middaugh | Internal Medicine | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2012-04-16 |
1922231810 | Austin Diagnostic Clinic, Pa | Optometrist | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2009-08-26 |
1255571477 | Carmela K Hubler | Registered Nurse | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2009-02-27 |
1598923914 | Karol L Babyak-moore | Audiologist | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2008-06-02 |
1568637452 | Janet L Davila | Audiologist | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2008-04-23 |
1346434511 | Neelu Kohli | Dietitian, Registered | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2007-08-30 |
1477744266 | Jeffrey Michael Boos | Dermatology | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2007-08-06 |
1902096555 | Joseph Imsais | Internal Medicine | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2007-07-30 |
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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 | 207RH0003X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Hematology & Oncology |
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205079373 | Andrae Lavon Vandross | Internal Medicine | 12221 Renfert Way, Suite 120 and 300, Austin, TX 78758 | 2009-04-19 |
1982661674 | Shubhada S. Shrikhande | Internal Medicine | 12221 Renfert Way Ste 300, Austin, TX 78758-5453 | 2006-04-27 |
1134186166 | Rene Castillo | Internal Medicine | 901 West 38th St., Suite 200, Austin, TX 78705-1165 | 2006-04-26 |
1124089412 | Christopher Owen Ruud | Internal Medicine | 901 W 38th St Ste 200, Austin, TX 78705-1165 | 2006-03-28 |
1215912076 | Uri M Mintz | Internal Medicine | 11044 Research Blvd, D400, Austin, TX 78759-5263 | 2005-12-14 |
1477815249 | Tara Kaufmann | Internal Medicine | 1601 Trinity St, Austin, TX 78712-1765 | 2012-06-08 |
1972770303 | Texas Oncology Pa | Internal Medicine | 4101 James Casey St, Suite 100, Austin, TX 78745-3325 | 2008-05-14 |
1164502423 | Mamta Kalidas | Internal Medicine | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2006-10-17 |
1467548628 | Allison Elaine Gorrebeeck | Internal Medicine | 12221 Renfert Way Ste 300, Austin, TX 78758 | 2006-10-05 |
1003839820 | Debra Ann Patt | Internal Medicine | 6204 Balcones Dr, Austin, TX 78731 | 2006-07-25 |
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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.