THE AUSTIN DIAGNOSTIC CLINIC, PLLC (NPI# 1407839129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407839129 |
| Entity Type | Organization |
| Organization Name | THE AUSTIN DIAGNOSTIC CLINIC, PLLC |
| Practice Address |
12221 N Mo Pac Expwy Dept of Allergy Austin TX 78758 |
| Mailing Address |
2000 Health Park Dr Dept Of Brentwood TN 37027-4525 |
| Practice Telephone | 5129014002 |
| Practice Fax Number | 5129013902 |
| Mailing Telephone | 6153725004 |
| Mailing Fax Number | 8668314898 |
| Enumeration Date | 2005-11-28 |
| 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 | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 140347902 | 05 | |
| TX | 140347952 | 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 |
| 1104803816 | The Austin Diagnostic Clinic, Pllc | Internal Medicine | 12221 Mo Pac Expwy North, Dept of Cardiology, Austin, TX 78758 | 2005-12-23 |
| 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 N MO PAC EXPWY DEPT OF ALLERGY |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758 |
| 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 | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891259016 | Allergy Partners of Texas, Inc | Allergy & Immunology | 3410 Far West Blvd Ste 146, Austin, TX 78731-3167 | 2019-01-23 |
| 1154506673 | Maria G Gutierrez Md Pa | Allergy & Immunology | 720 W 34th St Ste 201, Ste. 200, Austin, TX 78705-1205 | 2008-01-03 |
| 1669654158 | Hetu Parekh | Allergy & Immunology | 10801-2 N Mopac Expy, Ste 150, Austin, TX 78759-5973 | 2007-11-27 |
| 1578625190 | Austin Family Allergy & Asthma Pa | Allergy & Immunology | 10801-2 North Mopac Expwy, Ste 150, Austin, TX 78759-5973 | 2006-12-14 |
| 1821157579 | Austin Regional Clinic, Pa | Allergy & Immunology | 6210 E Us Hwy 290, Suite 420 - Credentialing, Austin, TX 78723-1098 | 2006-12-08 |
| 1417976788 | Manda L Hall | Allergy & Immunology | 17064 Conway Springs Ct, Austin, TX 78717-2989 | 2006-07-18 |
| 1932125945 | Russell R Roby Md Pa | Allergy & Immunology | 4407 Beecaves Rd #122, Austin, TX 78746 | 2006-07-14 |
| 1831142918 | Ronald L Cox Md, Inc | Allergy & Immunology | 6611 River Place Blvd Ste 301, Austin, TX 78730-1162 | 2006-05-18 |
| 1770550535 | William Charles Howland IIi | Allergy & Immunology | 11645 Angus Rd # A1, Austin, TX 78759-4100 | 2006-03-01 |
| 1922075787 | Allen Keith Lieberman | Allergy & Immunology | 10801 North Md Pac Expressway, Building II Suite 150, Austin, TX 78759 | 2006-03-01 |
| 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.