THE AUSTIN DIAGNOSTIC CLINIC, PLLC (NPI# 1740255926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740255926 |
| Entity Type | Organization |
| Organization Name | THE AUSTIN DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | AUSTIN DIAGNOSTIC CLINIC |
| Practice Address |
12221 Mo Pac Expwy North Dept of Urology Austin TX 78758 |
| Mailing Address |
2000 Health Park Dr Dept Of Brentwood TN 37027-4525 |
| Practice Telephone | 5129014021 |
| Practice Fax Number | 5129013921 |
| Mailing Telephone | 6153725004 |
| Mailing Fax Number | 8668314898 |
| Enumeration Date | 2006-02-21 |
| 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 | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 140347949 | 05 | |
| TX | 140347960 | 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 |
| 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 UROLOGY |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104803816 | The Austin Diagnostic Clinic, Pllc | Internal Medicine | 12221 Mo Pac Expwy North, Dept of Cardiology, Austin, TX 78758 | 2005-12-23 |
| 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 | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215443064 | Greater Austin Urology, Pllc | Urology | 11673 Jollyville Rd Ste B101, Austin, TX 78759 | 2017-12-15 |
| 1366853152 | Lawrence Tsai | Urology | 12319 N Mopac Expy Ste 200, Austin, TX 78758-2497 | 2014-05-14 |
| 1558780031 | Rachel Sosland | Urology | 4207 James Casey St Ste 107, Austin, TX 78745-1192 | 2014-04-10 |
| 1457676215 | Kelly Jeanne Nast | Urology | 1301 Barbara Jordan Blvd Ste 302, Austin, TX 78723-3078 | 2010-04-05 |
| 1477795458 | Edward Charles Osterberg IIi | Urology | 1400 North Interstate 35 Frontage Rd, Suite Cl 300, Austin, TX 78701-1996 | 2009-04-06 |
| 1245497387 | Danielle Dienert Sweeney | Urology | 916 Springdale Rd Bldg 5-102, Austin, TX 78702 | 2008-05-16 |
| 1023100492 | J Stuart Wolf Jr. | Urology | 1400 Barbara Jordan Blvd Ste 1.114, Mailcode R1800, Austin, TX 78723-3092 | 2006-09-29 |
| 1982601274 | Jeffrey Neal Kocurek | Urology | 1301 W 38th St, Ste. #200, Austin, TX 78705-1000 | 2005-07-01 |
| 1083618706 | Joy Nielsen | Urology | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2005-06-10 |
| 1548262728 | Jose Carlos Cortez | Urology | 1301 Barbra Jordan Blvd., Suite 302, Austin, TX 78723-3078 | 2005-06-01 |
| Find all providers in AUSTIN | ||||
Please comment or provide details below to improve the information on THE AUSTIN DIAGNOSTIC CLINIC, PLLC.
| 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.