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General NPI Number Information
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NPI Number | 1033099676
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Entity Type | Organization
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Legal Business Name | ASC - NORTH AUSTIN LLC
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 3207 GREENLAWN BLVD STE 100
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City | ROUND ROCK
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State | TX
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Zip | 78664-7397
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Country | US
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Telephone | 512-419-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 6210 E HWY 290
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City | AUSTIN
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State | TX
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Zip | 78723-1142
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | ANAS DAGHESTANI
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Credential | MD
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Telephone | 512-419-0707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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