Healthcare Provider Details

I. General information

NPI: 1033099676
Provider Name (Legal Business Name): ASC - NORTH AUSTIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3207 GREENLAWN BLVD STE 100
ROUND ROCK TX
78664-7397
US

IV. Provider business mailing address

6210 E HWY 290
AUSTIN TX
78723-1142
US

V. Phone/Fax

Practice location:
  • Phone: 512-419-0707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANAS DAGHESTANI
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 512-419-0707