Organization Name:  THE AUSTIN DIAGNOSTIC CLINIC, PLLC


Practice Location:
12221 N MO PAC EXPWY DEPT OF ALLERGY AUSTIN, TX 78758 US
Tel: 512-901-4002  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	207K00000X	Physicians Allergy & Immunology

Other Provider Identifiers:

Issuer	Number	State	Type
	140347902	TX	05
	140347952	TX	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin