THE AUSTIN DIAGNOSTIC CLINIC, PLLC (NPI# 1104803816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104803816 |
| Entity Type | Organization |
| Organization Name | THE AUSTIN DIAGNOSTIC CLINIC, PLLC |
| Practice Address |
12221 Mo Pac Expwy North Dept of Cardiology Austin TX 78758 |
| Mailing Address |
2000 Health Park Dr Dept Of Brentwood TN 37027-4525 |
| Practice Telephone | 5129014001 |
| Practice Fax Number | 5129013901 |
| Mailing Telephone | 6153725004 |
| Mailing Fax Number | 8668314898 |
| Enumeration Date | 2005-12-23 |
| 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 |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 140347904 | 05 |
| 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 |
| 1407839129 | The Austin Diagnostic Clinic, Pllc | Allergy & Immunology | 12221 N Mo Pac Expwy, Dept of Allergy, Austin, TX 78758 | 2005-11-28 |
| 1003259763 | The Austin Diagnostic Clinic, Pllc | Technician, Pathology | 12221 N Mopac Expy, Austin, TX 78758 | 2013-04-12 |
| 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 MO PAC EXPWY NORTH DEPT OF CARDIOLOGY |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740255926 | The Austin Diagnostic Clinic, Pllc | Urology | 12221 Mo Pac Expwy North, Dept of Urology, Austin, TX 78758 | 2006-02-21 |
| 1912971961 | The Austin Diagnostic Clinic, Pllc | Otolaryngology | 12221 Mo Pac Expwy North, Dept of Ent, Austin, TX 78758 | 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 |
| 1497729685 | The Austin Diagnostic Clinic, Pllc | Internal Medicine | 12221 Mo Pac Expwy North, Dept of Nephrology, Austin, TX 78758 | 2006-02-14 |
| 1568436764 | The Austin Diagnostic Clinic, Pllc | Optometrist | 12221 Mo Pac Expwy North, Dept of Ophthalmology, Austin, TX 78758 | 2006-02-14 |
| 1265406466 | The Austin Diagnostic Clinic, Pllc | Psychiatry & Neurology | 12221 Mo Pac Expwy North, Dept of Neurology, Austin, TX 78758 | 2006-02-14 |
| 1548248750 | The Austin Diagnostic Clinic, Pllc | Internal Medicine | 12221 Mo Pac Expwy North, Dept of Gastroenterology, Austin, TX 78758 | 2006-01-06 |
| 1013994722 | The Austin Diagnostic Clinic, Pllc | Dermatology | 12221 Mo Pac Expwy North, Dept of Dermatology, Austin, TX 78758 | 2005-12-23 |
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433455 | Chalkias Cardiology Pllc | Internal Medicine | 11671 Jollyville Rd Ste 120, Austin, TX 78759-4141 | 2020-10-01 |
| 1992318992 | Us Televero Health Pa | Internal Medicine | 1204 Rockcliff Rd, Austin, TX 78746-1604 | 2020-08-28 |
| 1356869804 | Legacy Heart Care of Midtown Austin, LLC | Internal Medicine | 901 W 38th St Ste 403, Austin, TX 78705-1162 | 2017-09-05 |
| 1346768892 | Legacy Heart Care of South Austin, LLC | Internal Medicine | 1807 W Slaughter Ln Ste 485, Austin, TX 78748-6204 | 2017-09-05 |
| 1982964037 | Michael Rotman | Internal Medicine | 311 Addie Roy Rd, Austin, TX 78746-4125 | 2012-05-23 |
| 1811254857 | Itamar Birnbaum | Internal Medicine | 1015 E 32nd St Ste 508, Austin, TX 78705 | 2012-04-16 |
| 1366775942 | Cardiovascular Specialists of Texas, P.a. | Internal Medicine | 4316 James Casey, Building C, Austin, TX 78745-1157 | 2009-09-14 |
| 1649503236 | Cardiovascular Specialists of Texas, P.a. | Internal Medicine | 2555 Western Trls. Blvd., Ste. 102, Austin, TX 78745-1574 | 2009-09-14 |
| 1760610620 | Cardiovascular Specialists of Texas, P.a. | Internal Medicine | 5656 Bee Caves Road, Bldg. M, Ste. 300, Austin, TX 78746-5280 | 2009-06-30 |
| 1033347992 | Cardiovascular Specialists of Texas, P.a. | Internal Medicine | 11111 Research Blvd., Suite 360, Austin, TX 78759-5264 | 2009-06-30 |
| Find all providers in AUSTIN | ||||
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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.