MEDICARE: ASC - NORTH AUSTIN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1033099676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASC - NORTH AUSTIN LLC

Provider Business Mailing Address
First Line	:	6210 E HWY 290
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-1142
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3207 GREENLAWN BLVD STE 100
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-7397
Country	:	US
Telephone Number	:	512-419-0707
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	ANAS DAGHESTANI
Credential	:	MD
Telephone Number	:	512-419-0707

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	05/06/2026

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