THE AUSTIN DIAGNOSTIC CLINIC, PLLC (NPI# 1467426205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467426205 |
| Entity Type | Organization |
| Organization Name | THE AUSTIN DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | AUSTIN DIAGNOSTIC CLINIC |
| Practice Address |
2400 Cedar Bend Dr Dept of Pediatrics Austin TX 78758 |
| Mailing Address |
2000 Health Park Dr Dept Of Brentwood TN 37027-4525 |
| Practice Telephone | 5129014016 |
| Practice Fax Number | 5129013948 |
| Mailing Telephone | 6153725004 |
| Mailing Fax Number | 8668314898 |
| Enumeration Date | 2006-02-16 |
| 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 | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 140347920 | 05 |
| Other Name | Type Code |
|---|---|
| Austin Diagnostic Clinic | Doing Business As Name - Organization |
| 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 |
| 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 |
| 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 |
2400 CEDAR BEND DR DEPT OF PEDIATRICS |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982604161 | Jennifer A Arnecilla | Family Medicine | 2400 Cedar Bend Dr, Austin, TX 78758-5378 | 2005-07-28 |
| 1285108696 | Lauren C Juarez | Nurse Practitioner | 2400 Cedar Bend Dr, Austin, TX 78758-5378 | 2019-01-18 |
| 1043755473 | Kay Frazier | Registered Nurse | 2400 Cedar Bend Dr, Austin, TX 78758-5378 | 2016-12-20 |
| 1336570605 | Kyla M. Carlson | Nurse Practitioner | 2400 Cedar Bend Dr, Austin, TX 78758-5378 | 2013-12-11 |
| 1073854733 | Wendy Dennise Csaki | Nurse Practitioner | 2400 Cedar Bend Dr, Austin, TX 78758-5378 | 2013-03-06 |
| 1104188952 | Zoabe Feroze Hafeez | Pediatrics | 2400 Cedar Bend Dr, Austin, TX 78758-5378 | 2012-06-07 |
| 1205103132 | Paul Carothers | Family Medicine | 2400 Cedar Bend Dr, Austin, TX 78758-5378 | 2011-11-21 |
| 1104152776 | Julie A Isaac | Nurse Practitioner | 2400 Cedar Bend Dr, Austin, TX 78758-5378 | 2009-11-02 |
| 1003043134 | Lorraine E. Powell | Pediatrics | 2400 Cedar Bend Dr, Austin, TX 78758-5378 | 2009-06-16 |
| 1275776635 | Shirin Mary Priya Naidu | Family Medicine | 2400 Cedar Bend Dr, Austin, TX 78758-5378 | 2009-04-15 |
| Find all providers in the same location | ||||
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368591 | Tch Pediatrics Inc | Pediatrics | 4207 James Casey St Ste 111, Austin, TX 78745-3362 | 2020-08-28 |
| 1245858166 | Patricia Bailey Nicol | Pediatrics | 6101 E Oltorf St # Tx78741, Austin, TX 78741-7500 | 2020-07-07 |
| 1962061986 | Tch Pediatrics Inc | Pediatrics | 2911 Medical Arts St Ste 7, Austin, TX 78705-3302 | 2019-06-12 |
| 1316502875 | Tch Pediatric Associates, Inc | Pediatrics | 1111 W 34th St Ste 102, Austin, TX 78705-1916 | 2019-05-09 |
| 1871158816 | Sara Marie Dryden | Pediatrics | 4900 Mueller Blvd Ste 35.066c, Austin, TX 78723-3079 | 2019-05-06 |
| 1285190066 | Raegan Oneill | Pediatrics | 1621 E 6th St Apt 1230, Austin, TX 78702-3350 | 2019-02-16 |
| 1376023267 | Tch Pediatric Associates, Inc | Pediatrics | 2911 Medical Arts St Ste 20, Austin, TX 78705-3302 | 2018-08-20 |
| 1174012272 | Amanda Vela | Pediatrics | 4900 Mueller Blvd Ste 3s.066, Austin, TX 78723-3079 | 2018-05-03 |
| 1316434236 | Yasaman Ahmadieh | Pediatrics | 4900 Mueller Boulevard, Suite 3s.066c, Austin, TX 78723 | 2018-04-16 |
| 1083120257 | Rachel Aujla Quirt | Pediatrics | 1301 Barbara Jordan Blvd Ste 200b, Austin, TX 78723-3078 | 2017-12-23 |
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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.