Health and Human Services Commission - Texas · 2019-09-11 · texas health and human services hhs.texas.gov name lice nse num ber ccn expira tion effec tive services/accredita tion/status

1

Texas Health and Human Services ● hhs.texas.gov

Health and Human Services Commission

Directory of Ambulatory Surgical Centers

NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA

TION/STATUS ADDRESS CITY

STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

ABILENE

CATARACT &

REFRACTIVE

SURGERY

CENTER

353 45C0001

085

02/29/2

020

08/31/

1987

AAAHC, For Profit,

Opthalmology

2120

ANTILLEY

ROAD

ABILENE TX 79606 325695

2020

TAYLOR 1A

BURTON

HILLS

BLVD

ATTN: L &

C

NASHVIL

LE

TN 37215 3

ABILENE CENTER FOR

ORTHOPEDIC

AND

MULTISPECI

ALTY

SURGERY,

LLC

1303

97

07/31/2

020

07/31/

2018

For Profit, Orthopedic, Otolaryngology, Pain

Management

6449 CENTRAL

PARK BLVD

ABILENE TX 79606 325232

8110

TAYLOR 6449 CENTRAL

PARK BLVD

ABILENE TX 79606 4

ABILENE

ENDOSCOPY

CENTER

301 45C0001

181

12/31/2

019

12/06/

1994

For Profit,

Gastroenterology

1249

AMBLER

AVENUE

SUITE 100

ABILENE TX 79601 325677

2626

TAYLOR 1 A

BURTON

HILLS

BLVD ATTENTION

: L&C

NASHVIL

LE

TN 37215 3

2


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

ABILENE

SPINE &

JOINT

SURGERY

CENTER PA

7117 45C0001

261

09/30/2

020

09/21/

1999

AAAHC, For Profit, Pain

Management

1888

ANTILLEY

ROAD

ABILENE TX 79606 325795

1888

TAYLOR 1888

ANTILLEY

ROAD

ABILENE TX 79606 1

ABILENE

SURGERY

CENTER LLC

1300

00

45C0001

493

03/31/2

021

03/11/

2009

For Profit, Opthalmology,

Other Services

5601

HEALTH

CENTER

DRIVE

ABILENE TX 79606 325690

4466

TAYLOR 5601

HEALTH

CENTER

DRIVE

ABILENE TX 79606 4

ABILENE WHITE ROCK

SURGERY

CENTER, LLC

1302

69

45C0001

590

12/31/2

019

12/01/

2015

Foot, For Profit, Neurological, Pain

Management

2401 N TREADAWA

Y

BOULEVAR

D

ABILENE TX 79604 325676

7700

TAYLOR PO BOX

2587

ABILENE TX 79604 2

ACPS - THE

SURGICENTR

E

1303

30

04/30/2

021

04/28/

2017

AAAASF, Plastic 12727

KIMBERLEY

LANE

SUITE 100

HOUSTO

N

TX 77024 713799

9999

HARRIS 12727

KIMBERLEY

LANE

SUITE 100

HOUSTO

N

TX 77024 4

ACUTE AND

CHRONIC

PAIN

MANAGEMEN

T CENTER

7835 45C0001

323

03/31/2

020

03/25/

2002

For Profit, Pain

Management

#24 CARE

CIRCLE

AMARILL

O

TX 79124 806353

6100

POTTER #24 CARE

CIRCLE

AMARILL

O

TX 79124 2

ADC ENDOSCOPY

SPECIALISTS

8375 45C0001

432

06/30/2

020

06/22/

2006

For Profit,

Gastroenterology

1 CARE

CIRCLE

AMARILL

O

TX 79124 806353

1769

POTTER 1 CARE

CIRCLE

AMARILL

O

TX 79124 4

ADVANCED

CARDIOVASC

ULAR

SURGERY

CENTER AT

METHODIST

WEST

HOUSTON

1303

11

11/30/2

020

11/28/

2016

AAAHC, Cardiovascular,

For Profit

18400

KATY

FREEWAY

SUITE 330

HOUSTO

N

TX 77094 281829

2226

HARRIS 18400

KATY

FREEWAY

SUITE 330

HOUSTO

N

TX 77094 2

3


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

ADVANCED

SURGERY

CENTER OF

SAN

ANTONIO

LLC

1302

16

45C0001

580

01/31/2

021

01/09/

2015

Cardiovascular, Foot, For

Profit, General, JC,

Neurological, OB/GYN,

Orthopedic, Pain

Management, Thoracic

18414 US

HIGHWAY

281 NORTH

SUITE 114

SAN

ANTONIO

TX 78259

-7611

210455

4150

BEXAR 18414 US

HIGHWAY

281 NORTH

SUITE 114

SAN

ANTONIO

TX 78259

-7611

3

ADVANCED

SURGICAL CARE OF

BOERNE LLC

1303

70

02/29/2

020

02/21/

2018

Foot, For Profit,

Neurological, Orthopedic,

Pain Management

138 OLD

SAN ANTONIO

ROAD

#400

BOERNE TX 78006 830428

3166

KENDALL 138 OLD

SAN ANTONIO

ROAD

#400

BOERNE TX 78006 3

ADVANCED

SURGICAL

CENTER

1304

04

09/30/2

020

09/25/

2018

Cardiovascular,

Endoscopy, Foot, For

Profit, Gastroenterology,

General, Neurological,

OB/GYN, Opthalmology,

Orthopedic,

Otolaryngology, Pain

Management, Plastic,

Thoracic, Urology

1901

MEDI-

PARK

BUILDING

C SUITE 1

AMARILL

O

TX 79106 806513

4677

POTTER 1901 MEDI

PARK

BUILDING

C SUITE 1

AMARILL

O

TX 79106 4

ADVANCED SURGICAL

CENTER LLC

1303

04

09/30/2

020

09/06/

2016


Orthopedic, Plastic

1018 E WHEATLAN

D ROAD

DUNCAN

VILLE

TX 75116 972646

1159

DALLAS 1018 E WHEATLAN

D ROAD

DUNCAN

VILLE

TX 75116 3

ALAMO CITY

SURGERY

CENTER PLLC

1302

38

05/31/2

021

05/22/

2015

Abortion, For Profit 7402 JOHN

SMITH

DRIVE,

SUITE 104

SAN

ANTONIO

TX 78229 210602

5776

BEXAR 7402 JOHN

SMITH

DRIVE,

SUITE 104

SAN

ANTONIO

TX 78229 5

ALLIANCE

SURGICAL

CENTER

1302

81

03/31/2

020

03/03/

2016

For Profit, Oral, Pain

Management

3800

NORTH

SHEPHERD

DRIVE #3B

HOUSTO

N

TX 77018 713701

9845

HARRIS 3800

NORTH

SHEPHERD

DRIVE #3B

HOUSTO

N

TX 77018 5

AMARILLO

CATARACT

AND EYE

SURGERY

CENTER LTD

6946 45C0001

127

12/31/2

020

01/01/

1999

For Profit, Opthalmology 7310

FLEMING

AVENUE

AMARILL

O

TX 79106 806354

8891

POTTER 7310

FLEMING

AVENUE

AMARILL

O

TX 79106 3

4


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

AMARILLO

COLONOSCO

PY CENTER

LP

1300

91

45C0001

535

09/30/2

019

09/09/

2011

Endoscopy, For Profit,

Gastroenterology,

General

800 QUAIL

CREEK

DRIVE

SUITE 102

AMARILL

O

TX 79124 806367

8537

POTTER 800 QUAIL

CREEK

DRIVE

SUITE 102

AMARILL

O

TX 79124 2

AMARILLO

ENDOSCOPY

CENTER

7790 45C0001

302

09/30/2

021

09/25/

2001

For Profit,

Gastroenterology

6833 PLUM

CREEK

AMARILL

O

TX 79124 806467

9820

POTTER 6833 PLUM

CREEK

AMARILL

O

TX 79124 2

AMBULATOR

Y SURGICAL

INSTITUTE OF DALLAS,

LLC

1301

52

45C0001

573

07/31/2

021

07/11/

2013


Management

17051

DALLAS

PARKWAY,

SUITE 100

ADDISON TX 75001 972234

4740

DALLAS 7920 BELT

LINE

ROAD,

SUITE 940

DALLAS TX 75254 2

AMERICAN

SURGERY

CENTER

1304

35

05/31/2

021

05/22/

2019


VISTA DEL

NORTE

SAN

ANTONIO

TX 78216 210692

0218

BEXAR 12838

VISTA DEL

NORTE

SAN

ANTONIO

TX 78216 6

ARISTO

SURGERY

CENTER

1304

02

06/30/2

020

09/14/

2018

Foot, For Profit,

Orthopedic, Pain

Management

10710

KUYKENDA

HL ROAD

SUITE 250

THE

WOODLA

NDS

TX 77381 281292

6800

MONTGO

MERY

10710

KUYKENDA

HL ROAD

SUITE 250

THE

WOODLA

NDS

TX 77381 3

ARMC

SURGERY

CENTER

8660 450558 06/30/2

020

06/01/

2008

Foot, For Profit, General,

OB/GYN, Oral,

Orthopedic,

Otolaryngology, Plastic

6399

DIRECTOR

S

PARKWAY

ABILENE TX 79606 325794

5450

TAYLOR 6250 US

HIGHWAY

83-84

ABILENE TX 79606 5

ASC CENTER

FOR CHANGE

LLC

1300

48

07/31/2

020

07/02/

2010

For Profit, General, Other

Services, Plastic

119

VISION PARK

BOULEVAR

D

SHENAND

OAH

TX 77384 281419

1123

MONTGO

MERY

119

VISION PARK

BOULEVAR

D

SHENAND

OAH

TX 77384 2

ASPIRE

SURGERY

CENTER

1303

69

01/31/2

020

02/21/

2018




Orthopedic,


Management

3726

DACOMA

STREET

SUITE 135

HOUSTO

N

TX 77092 832831

2525

HARRIS 3726

DACOMA

STREET

SUITE 135

HOUSTO

N

TX 77092 2

5


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

AUA

SURGICAL

CENTER LLC

1302

44

45C0001

581

07/31/2

021

07/07/

2015

AAAHC, For Profit,

OB/GYN, Plastic, Urology

8207 WEST

AMARILLO

BOULEVAR

D

AMARILL

O

TX 79124 806350

7388

RANDALL 8207 WEST

AMARILLO

BOULEVAR

D

AMARILL

O

TX 79124 6

AUSTIN

ACCESS CARE

1303

75

03/31/2

020

03/15/

2018

For Profit, Other Services 8620

BURNET

ROAD

SUITE 400

AUSTIN TX 78757 512334

1810

TRAVIS 8620

BURNET

ROAD

SUITE 400

AUSTIN TX 78757 2

AUSTIN

DIAGNOSTIC CLINIC

AMBULATOR

Y SURGERY

CENTER

1303

82

03/31/2

020

04/13/

2018


Profit, Gastroenterology, General, OB/GYN,

Opthalmology,

Orthopedic,


Management, Urology

7600-A

NORTH CAPITAL

OF TEXAS

HIGHWAY

AUSTIN TX 78731 512901

4029

TRAVIS 7600-A

NORTH CAPITAL

OF TEXAS

HIGHWAY

AUSTIN TX 78731 6

AUSTIN

ENDOSCOPY

CENTER

1304

12

09/30/2

020

12/03/

2018

AAAHC, Endoscopy, For


General

8015

SHOAL

CREEK

SUITE 300

AUSTIN TX 78757 512371

1579

TRAVIS 8015

SHOAL

CREEK

SUITE 300

AUSTIN TX 78757 6

AUSTIN

ENDOSCOPY

CENTER

1304

13

09/30/2

020

12/03/

2018



General

4310

JAMES

CASEY STREET

SUITE 4B

2ND FLOOR

AUSTIN TX 78745 512532

8000

TRAVIS 4310

JAMES

CASEY STREET

SUITE 4B

2ND FLOOR

AUSTIN TX 78745 3

AUSTIN EYE

LASER AND

SURGICENTE

R

7153 45C0001

271

02/29/2

020

02/10/

2000

AAAHC, For Profit,

Opthalmology

11901

JOLLYVILLE

ROAD

AUSTIN TX 78759 512250

2020

TRAVIS 11901

JOLLYVILLE

ROAD

AUSTIN TX 78759 2

AUSTIN

FERTILITY

SURGERY

CENTER

1302

93

06/30/2

020

06/10/

2016

AAAHC, For Profit,

OB/GYN, Other Services,

Urology

6500

NORTH

MOPAC

EXPRESSW

AY BLDG 3

#3104

AUSTIN TX 78731 512451

0149

TRAVIS 6500

NORTH

MOPAC

EXPRESSW

AY BLDG 3

#3104

AUSTIN TX 78731 2

6


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

AUSTIN

MIDTOWN

AMBULATOR

Y SURGERY

CENTER

1303

79

01/31/2

020

04/04/

2018

For Profit, Neurological 901 WEST

38TH

STREET

SUITE 101

AUSTIN TX 78705 512992

0027

TRAVIS 901 WEST

38TH

STREET

SUITE 101

AUSTIN TX 78705 1

AZURA

SURGERY

CENTER

STAR

1303

73

03/31/2

020

03/02/

2018

For Profit, Other Services 301 NORTH

FRIO

STREET

SAN

ANTONIO

TX 78207 210487

7827

BEXAR 52 EAST

SWEDESFO

RD ROAD

SUITE 110

MALVERN PA 19355 4

AZURA SURGICAL

CENTER

HOUSTON

1303

57

12/31/2

019

12/27/

2017

For Profit, Other Services 8537 C GULF

FREEWAY

HOUSTO

N

TX 77017 832386

0900

HARRIS 52 EAST SWEDESFO

RD ROAD

SUITE 110

MALVERN PA 19355 2

BAILEY

SQUARE

SURGERY

CENTER

265 45C0001

004

04/30/2

020

04/20/

1993

AAAHC, Endoscopy, Foot,

For Profit,

Gastroenterology,

General, OB/GYN,

Opthalmology, Oral,

Orthopedic,



Urology

1111 WEST

34TH

STREET

AUSTIN TX 78705 512454

6753

TRAVIS 1111 WEST

34TH

STREET

AUSTIN TX 78705 13

BAPTIST

BEAUMONT

SURGICAL

AFFILIATES

384 45C0001

240

08/31/2

021

08/11/

1998

Foot, For Profit, JC,


Pain Management

3560

COLLEGE

STREET

BEAUMO

NT TX 77701 409

835

7070

JEFFERSO

N

3560

COLLEGE

STREET

BEAUMO

NT TX 77701 6

BASSETT

SURGERY

CENTER

8178

03/31/2

020

03/04/

2005

For Profit, Orthopedic,

Pain Management

6211

EDGEMERE

EL PASO TX 79925 915881

1010

EL PASO 6211

EDGEMERE

EL PASO TX 79925 2

BAY AREA

ENDOSCOPY

1301

76

45C0001

194

12/31/2

019

02/12/

2014


Gastroenterology, JC

444 FM

1959

SUITE B

HOUSTO

N

TX 77034 281481

9400

HARRIS 444 FM

1959

SUITE B

HOUSTO

N

TX 77034 4

7


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

BAY AREA

HOUSTON

ENDOSCOPY

CENTER

1301

34

45C0001

453

12/31/2

020

12/03/

2012

AAAHC, For Profit,

Gastroenterology

1015

MEDICAL

CENTER

BLVD

SUITE

1200

WEBSTER TX 77598 281554

3494

HARRIS 1015

MEDICAL

CENTER

BLVD

SUITE

1200

WEBSTER TX 77598 4

BAY AREA

SURGICARE

CENTER

315 45C0001

012

04/30/2

020

01/01/

1986


For Profit, Gastroenterology,



Oral, Orthopedic,



Urology

502

MEDICAL CENTER

BLVD

WEBSTER TX 77598 281332

2433

HARRIS 502

MEDICAL CENTER

BLVD

WEBSTER TX 77598 6

BAYLOR

AMBULATOR

Y

ENDOSCOPY

CENTER

8136 45C0001

377

11/30/2

019

11/10/

2004

Gastroenterology, Non-

Profit

4708

ALLIANCE

BLVD

SUITE 210

PLANO TX 75093 469

800

6021

COLLIN 4708

ALLIANCE

BLVD

SUITE 210

PLANO TX 75093 5

BAYLOR SCOTT &

WHITE

HEART AND

VASCULAR

HOSPITAL -

FORT WORTH

1302

05

09/30/2

020

09/18/

2014

Cardiovascular, For

Profit, JC

1400 8TH

AVENUE

FORT

WORTH

TX 76104 214820

0600

TARRANT 1400 8TH

AVENUE

FORT

WORTH

TX 76104 3

BAYLOR

SCOTT &

WHITE

SPORTS

SURGERY CENTER AT

THE STAR

1303

87

05/31/2

020

05/11/

2018

For Profit, General,

Orthopedic, Other

Services

3800

GAYLORD

PARKWAY

SUITE 410

FRISCO TX 75034 972668

5911

COLLIN 15305

DALLAS

PARKWAY

SUITE

1600

ADDISON TX 75001 6

BAYLOR

SCOTT &

WHITE

SURGERY

CENTER

WAXAHACHI

E

1301

73

09/30/2

019

01/10/

2014

Endoscopy, Foot,

Gastroenterology,

General, Non-Profit,


Orthopedic, Pain

Management, Urology

106 LUCAS WAXAHA

CHIE

TX 75165 469843

8000

ELLIS 106 LUCAS WAXAHA

CHIE

TX 75165 2

8


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

BAYLOR

SCOTT &

WHITE

SURGICAL

HOSPITAL AT

SHERMAN -

OUTPATIENT

1302

57

05/31/2

021

06/01/

2015

Cardiovascular, Det

Norske Veritas,



General, OB/GYN,

Opthalmology, Oral,

Orthopedic, Otolaryngology, Pain


Urology

3601

NORTH

CALAIS

STREET

SUITE A

SHERMAN TX 75090 903813

0999

GRAYSON 3601

NORTH

CALAIS

STREET

SUITE A

SHERMAN TX 75090 7

BAYLOR

SCOTT &

WHITE

SURGICAL

HOSPITAL AT

SHERMAN-

OPHTHALMO

LOGY

1302

56

670076 05/31/2

021

06/01/

2015

Det Norske Veritas, For

Profit, Opthalmology

1325

NORTH

TRAVIS

STREET

SHERMAN TX 75092 903870

0999

GRAYSON 3601

NORTH

CALAIS

STREET

SHERMAN TX 75090 2

BAYLOR SCOTT &

WHITE

SURGICAL

HOSPITAL-

FORT WORTH

1301

91

450880 12/31/2

019

06/11/

2014

For Profit, Pain

Management

914 LIPSCOMB

STREET

FORT

WORTH

TX 76104 817632

4534

TARRANT 914 LIPSCOMB

STREET

FORT

WORTH

TX 76104 1

BAYLOR

SCOTT &

WHITE

SURGICARE

7062 45C0001

039

07/31/2

021

07/16/

1999



Oral, Orthopedic, Other

Services, Otolaryngology,

Plastic, Urology

3920

WORTH

STREET

DALLAS TX 75246 214820

2581

DALLAS 3920

WORTH

STREET

DALLAS TX 75246 8

BAYLOR

SCOTT &

WHITE SURGICARE

FORT WORTH

1302

67

45C0001

357

11/30/2

019

11/16/

2015



General, OB/GYN, Opthalmology,

Orthopedic,



Urology

750 12TH

AVENUE

FORT

WORTH

TX 76104 817334

5100

TARRANT 15305

DALLAS

PARKWAY SUITE

1600

ADDISON TX 75001 14

9


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

BAYLOR

SCOTT &

WHITE

SURGICARE

AT

CENTENNIAL

8203 45C0001

396

04/30/2

021

04/12/

2005



General, Opthalmology,

Oral, Orthopedic,


Management, Plastic

4401 COIT

ROAD

SUITE 100

FRISCO TX 75035 214619

0120

COLLIN 4401 COIT

ROAD

SUITE 100

FRISCO TX 75035 6

BAYLOR

SCOTT & WHITE

SURGICARE

AT PLANO

ALLIANCE

1303

86

05/31/2

020

05/07/

2018


Gastroenterology, General, OB/GYN,

Orthopedic, Other


Pain Management,

Urology

4825

ALLIANCE

SUITE 300

PLANO TX 75093 469325

8693

COLLIN 15305

DALLAS PARKWAY

SUITE

1600

ADDISON TX 75001 6

BAYLOR

SCOTT &

WHITE

SURGICARE

CARROLLTON

7914 45C0001

318

01/31/2

021

01/17/

2003


Pain Management

4780

JOSEY

LANE

NORTH

CARROLL

TON

TX 75010 972395

0440

DENTON 4780

JOSEY

LANE

NORTH

CARROLL

TON

TX 75010 3

BAYLOR

SCOTT &

WHITE SURGICARE

GRANBURY

1300

06

45C0001

471

04/30/2

021

04/17/

2009



General, JC, Opthalmology, Oral,

Orthopedic,



Urology

1717

PALUXY

ROAD

GRANBUR

Y

TX 76048 817579

8863

HOOD 1717

PALUXY

ROAD

GRANBUR

Y

TX 76048 5

BAYLOR

SCOTT &

WHITE

SURGICARE

NORTH

DALLAS

1302

58

45C0001

133

09/30/2

021

09/15/

2015



General, JC,

Opthalmology,

Orthopedic,

Otolaryngology, Pain Management, Plastic,

Urology

12230

COIT

ROAD,

SUITE 200

DALLAS TX 75251 469374

6400

DALLAS 12230

COIT

ROAD,

SUITE 200

DALLAS TX 75251 6

BAYLOR

SCOTT &

WHITE

SURGICARE-

NORTH

GARLAND

8192 45C0001

393

04/30/2

021

04/04/

2005



General, JC, Orthopedic,

Other Services,



Urology

7150

NORTH

GEORGE

BUSH

HIGHWAY

SUITE 101

GARLAND TX 75044 214703

1800

DALLAS 7150

NORTH

GEORGE

BUSH

HIGHWAY

SUITE 101

GARLAND TX 75044 6

10


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

BAYLOR

SCOTT &

WHITE

SURGICARE-

PLANO

8585 45C0001

355

11/30/2

019

11/15/

2007




Orthopedic, Other


Pain Management,

Plastic, Urology

1701 OHIO

DRIVE

PLANO TX 75093

-5208

214291

3000

COLLIN 1701 OHIO

DRIVE

PLANO TX 75093

-5208

7

BAYLOR SCOTT &

WHITE

SURGICARE

PLANO

PARKWAY

1300

82

45C0001

214

03/31/2

021

04/01/

2011

AAAHC, For Profit, Orthopedic, Pain

Management

4031 WEST PLANO

PARKWAY

SUITE 100

PLANO TX 75093 469326

0202

COLLIN 4031 WEST PLANO

PARKWAY

SUITE 100

PLANO TX 75093 1

BAYLOR

SCOTT &

WHITE

SURGICARE-

ROCKWALL

8418 45C0001

364

10/31/2

020

09/01/

2006

Foot, For Profit,

Gastroenterology,

General, JC, OB/GYN,

Orthopedic,


Management, Plastic

825 WEST

YELLOW

JACKET

LANE

ROCKWA

LL

TX 75087 972772

6166

ROCKWA

LL

825 WEST

YELLOW

JACKET

LANE

ROCKWA

LL

TX 75087 4

BAYLOR

SCOTT & WHITE

SURGICARE-

BEDFORD

322 45C0001

191

12/31/2

019

12/12/

1995


OB/GYN, Orthopedic, Pain

Management, Urology

1600

CENTRAL DRIVE

SUITE 180

BEDFORD TX 76022 817571

1999

TARRANT 1600

CENTRAL DRIVE

SUITE 180

BEDFORD TX 76022 6

BAYLOR

SCOTT &

WHITE

SURGICARE-

GRAPEVINE

7819 45C0001

301

01/31/2

020

01/02/

2002




Orthopedic,



Thoracic, Urology

2040 WEST

STATE

HIGHWAY

114

GRAPEVI

NE

TX 76051 817410

4300

TARRANT 2040 WEST

STATE

HIGHWAY

114

GRAPEVI

NE

TX 76051 8

BAYLOR

SCOTT & WHITE

SURGICARE-

MANSFIELD

1300

56

45C0001

486

10/31/2

020

10/14/

2010


Profit, Gastroenterology, General, JC, OB/GYN,

Orthopedic,



Urology

280

REGENCY

PARKWAY

MANSFIE

LD

TX 76063 817453

2744

TARRANT 280

REGENCY

PARKWAY

MANSFIE

LD

TX 76063 7

11


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

BAYLOR

SCOTT &

WHITE

TEXAS SPINE

& JOINT

HOSPITAL

SURGERY

CENTER

8239 450864 07/31/2

021

07/13/

2005


JC, OB/GYN,

Opthalmology, Oral,

Orthopedic,


Management, Plastic

3414

GOLDEN

ROAD

TYLER TX 75701 903525

3330

SMITH 1814

ROSELAND

BOULEVAR

D

TYLER TX 75701 4

BAYLOR

SCOTT&

WHITE

SURGICARE

DENTON

7012 45C0001

257

06/30/2

021

06/15/

1999

Foot, For Profit,

Gastroenterology,

General, JC,

Opthalmology,

Orthopedic,



Urology

350 SOUTH

IH 35 EAST DENTON TX 76205 940323

1393 DENTON 350 SOUTH

IH 35 EAST DENTON TX 76205 5

BAYLOR

SURGICARE

AT GARLAND

8512 45C0001

091

05/31/2

021

05/14/

2007

For Profit,

Gastroenterology,

General, JC, OB/GYN, Opthalmology,

Otolaryngology

530 CLARA

BARTON

SUITE 100

GARLAND TX 75042 972494

2400

DALLAS 530 CLARA

BARTON

SUITE 100

GARLAND TX 75042 6

BAYLOR

SURGICARE

AT HEATH

1303

89

03/31/2

020

05/22/

2018

Foot, For Profit,

Gastroenterology,

Orthopedic,


Management, Plastic

6435

SOUTH FM

549 SUITE

101

HEATH TX 75032 972722

9003

ROCKWA

LL

6435

SOUTH FM

549 SUITE

101

HEATH TX 75032 3

BAYLOR

SURGICARE

AT OAKMONT

8555 45C0001

196

09/30/2

019

09/06/

2007


OB/GYN, Orthopedic,


Management

7200

OAKMONT

BOULEVAR

D

FORT

WORTH

TX 76132 817732

3300

TARRANT 7200

OAKMONT

BOULEVAR

D

FORT

WORTH

TX 76132 4

BAYTOWN

ENDOSCOPY

CENTER

1302

70

11/30/2

019

11/30/

2015



General, Orthopedic, Other Services, Pain

Management, Plastic

910 NORTH

HWY 146

BAYTOW

N

TX 77522 281838

8020

HARRIS 910 NORTH

HWY 146

BAYTOW

N

TX 77522 3

12


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

BAYTOWN

HEART &

VASCULAR

SURGERY

CENTER

1302

95

45C0001

599

07/31/2

020

07/13/

2016

Cardiovascular, For

Profit, JC

1025

BIRDSONG

DRIVE,

SUITE B

BAYTOW

N

TX 77521 832926

4527

HARRIS 1025

BIRDSONG

DRIVE,

SUITE B

BAYTOW

N

TX 77521 2

BEAR CREEK

SURGERY

CENTER LLC

1302

14

45C0001

582

12/31/2

020

12/30/

2014


JC, Orthopedic,


Management, Plastic

100

BOURLAND

RD SUITE

110

KELLER TX 76248 817518

9130

TARRANT 100

BOURLAND

RD SUITE

110

KELLER TX 76248 3

BEAUMONT HEART &

VASCULAR

SURGERY

CENTER

1303

23

01/31/2

021

01/20/

2017

Cardiovascular, For

Profit, JC, Other Services

755 NORTH 11TH

STREET

SUITE

P3970B

BEAUMO

NT

TX 77702 409924

3996

JEFFERSO

N

755 NORTH 11TH

STREET

SUITE

P3970B

BEAUMO

NT

TX 77702 12

BELEZA

SURGERY

CENTER LLC

1303

80

04/30/2

020

04/06/

2018

For Profit, Plastic 9899

TOWNE

LAKE

PARKWAY

SUITE 200

CYPRESS TX 77433 713799

2278

HARRIS 6400

FANNIN

STREET

SUITE

2100

HOUSTO

N

TX 77030 2

BELTLINE

SURGERY

CENTER LLC

1300

32

45C0001

510

02/29/2

020

02/11/

2010


NORTH

BELTLINE ROAD

#100

SUNNYVA

LE

TX 75182 972203

8787

DALLAS 2858

NORTH

BELTLINE ROAD

#100

SUNNYVA

LE

TX 75182 3

BINZ

SURGERY

CENTER LLC

1302

31

45C0001

587

04/30/2

021

04/16/

2015

AAAHC, Foot, For Profit,

Gastroenterology,


OB/GYN, Oral,

Orthopedic,



Urology

1801 BINZ

STREET

SUITE 200

HOUSTO

N TX 77004 713600

8919 HARRIS 1801 BINZ

STREET

SUITE 200

HOUSTO

N TX 77004 3

BLUE STAR

SURGERY

CENTER

1303

98

08/31/2

020

08/27/

2018


Other Services, Pain

Management

2120

NORTH

MACARTHUR BLVD.

SUITE 200

IRVING TX 75061 972438

5232

DALLAS 2120

NORTH

MACARTHUR BLVD.

SUITE 200

IRVING TX 75061 3

13


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

BLUEBONNET

SURGERY

PAVILION

LLC

1302

33

45C0001

616

04/30/2

021

04/21/

2015


For Profit,

Gastroenterology,

General, Orthopedic, Pain

Management

1324

BROWN ST

SUITE 600

WAXAHA

CHIE

TX 75165 972937

4000

ELLIS 1324

BROWN ST

SUITE 600

WAXAHA

CHIE

TX 75165 3

BRAZOSPORT

EYE

INSTITUTE

157 45C0001

058

03/31/2

020

03/12/

1986


PARKING

WAY

LAKE

JACKSON

TX 77566 979297

2961

BRAZORI

A

103

PARKING

WAY

LAKE

JACKSON

TX 77566 2

BRECKENRID

GE SURGERY

CENTER

8161 45C0001

381

01/31/2

021

01/31/

2005

Foot, For Profit, Other

Services, Plastic

3201 EAST

GEORGE BUSH

FREEWAY

SUITE 100

RICHARD

SON

TX 75082 972470

5859

COLLIN 3201 EAST

GEORGE BUSH

FREEWAY

SUITE 100

RICHARD

SON

TX 75082 2

CALLOWAY

CREEK

SURGERY

CENTER

8592 45C0001

466

11/30/2

019

11/29/

2007



Oral, Orthopedic,


Management, Plastic

4300 CITY

POINT

DRIVE

SUITE 100

NORTH

RICHLAN

D HILLS

TX 76180 817548

4000

TARRANT 4300 CITY

POINT

DRIVE

SUITE 100

NORTH

RICHLAN

D HILLS

TX 76180 4

CAPLAN

SURGERY

CENTER

7960 45C0001

336

06/30/2

021

06/20/

2003


WESLAYAN

SUITE 400

HOUSTO

N

TX 77027 713526

1600

HARRIS 3100

WESLAYAN

SUITE 400

HOUSTO

N

TX 77027 3

CAREOS 352 45C0001

211

02/28/2

021

02/26/

1997

AAAHC, For Profit, Other

Services, Plastic

3705

MEDICAL

PARKWAY

SUITE 120

AUSTIN TX 78705 512458

4391

TRAVIS 3705

MEDICAL

PARKWAY

SUITE 120

AUSTIN TX 78705 2

CASTLE

HILLS

SURGERY

CENTER

1301

30

10/31/2

020

10/30/

2012


Pain Management

1646

LOCKHILL

SELMA RD

SAN

ANTONIO TX 78213 210218

5367 BEXAR 1646

LOCKHILL

SELMA RD

SAN

ANTONIO TX 78213 1

CASTLE

HILLS

SURGICARE

LLC

1303

33

45c00016

48

05/31/2

021

05/30/

2017

AAAASF, Endoscopy, For

Profit, Gastroenterology

4221

MEDICAL

PARKWAY

BUILDING

100 SUITE

100

CARROLL

TON

TX 75010 972939

2121

DENTON PO BOX

118438

CARROLL

TON

TX 75011 4

14


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

CATARACT &

SURGICAL

CENTER OF

LUBBOCK

7864 45C0001

310

08/31/2

021

08/12/

2002

For Profit, Opthalmology 5109 80TH

STREET

LUBBOCK TX 79424 806792

5900

LUBBOCK 5109 80TH

STREET

LUBBOCK TX 79424 3

CCA ASC, LLC 1302

94

07/31/2

020

07/01/

2016

Cardiovascular, For

Profit, JC

6200 I - 40

WEST

AMARILL

O

TX 79106 806354

9764

POTTER 6200 I - 40

WEST

AMARILL

O

TX 79106 2

CCRM

DALLAS

FORT WORTH

1303

94

05/31/2

020

07/17/

2018

For Profit, OB/GYN, Other

Services

8380

WARREN

PARKWAY

#201

FRISCO TX 75034 972325

7118

COLLIN 8380

WARREN

PARKWAY

#201

FRISCO TX 75034 2

CEDAR PARK SURGERY

CENTER LLC

1300

79

45C0001

517

02/28/2

021

02/21/

2011

AAAHC, Endoscopy, Foot, For Profit,

Gastroenterology,

General, OB/GYN,

Orthopedic, Pain

Management, Urology

351 CYPRESS

CREEK

ROAD

SUITE 102

CEDAR

PARK

TX 78613 512498

9006

WILLIAM

SON

351 CYPRESS

CREEK

ROAD

SUITE 102

CEDAR

PARK

TX 78613 5

CENTER FOR

ASSISTED

REPRODUCTI

ON

7127 45C0001

206

11/30/2

020

11/08/

1999

For Profit, OB/GYN,

Urology

1701 PARK

PLACE

AVENUE

BEDFORD TX 76022 817540

1157

TARRANT 1701 PARK

PLACE

AVENUE

BEDFORD TX 76022 2

CENTER FOR

SPECIALTY

SURGERY OF

AUSTIN

1302

48

45C0001

585

08/31/2

021

08/03/

2015

AAAHC, For Profit,

Opthalmology, Pain

Management, Plastic

8015

SHOAL

CREEK

BOULEVARD

SUITE100

AUSTIN TX 78757 512584

8410

TRAVIS 8015

SHOAL

CREEK

BOULEVARD

SUITE100

AUSTIN TX 78757 4

CENTRAL

PARK

SURGERY

CENTER

8380 45C0001

437

07/31/2

020

07/14/

2006


Gastroenterology,

Opthalmology,


Management

411

CENTRAL

PARK

DRIVE

ARLINGT

ON

TX 76014 817784

8300

TARRANT 411

CENTRAL

PARK

DRIVE

ARLINGT

ON

TX 76014 2

CENTRAL

PARK

SURGERY

CENTER

1301

16

45C0001

262

07/31/2

020

07/03/

2012


JC, Orthopedic,


Management, Plastic

900 WEST

38TH

STREET

SUITE 200

AUSTIN TX 78705 512323

2061

TRAVIS 900 WEST

38TH

STREET

SUITE 200

AUSTIN TX 78705 6

15


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

CENTRAL

TEXAS DAY

SURGERY

CENTER

1301

29

45C0001

036

10/31/2

020

10/24/

2012

For Profit, Pain

Management

3800 S W

S YOUNG

DRIVE

KILLEEN TX 76542 254213

0489

BELL 3800 S W

S YOUNG

DRIVE

SUITE 204

KILLEEN TX 76542 2

CENTRAL

TEXAS

ENDOSCOPY

CENTER

7156 45C0001

265

02/28/2

021

02/17/

2000


Gastroenterology

2206 EAST

VILLA

MARIA

ROAD

BRYAN TX 77802 979774

4211

BRAZOS 1A

BURTON

HILLS

BOULEVARD ATTN:

L&C

NASHVIL

LE

TN 37215

-6187

3

CENTRUM

SURGERY

CENTER LLC

1304

36

04/30/2

021

06/11/

2019



Management

2425

BABCOCK

ROAD

#106

SAN

ANTONIO TX 78229 830346

1130 BEXAR 2425

BABCOCK

ROAD

#106

SAN

ANTONIO TX 78229 2

CHI ST

LUKES

HEALTH

BAYLOR

MEDICAL

CENTER AMB

SURGERY

CENTER

1302

27

02/28/2

021

02/16/

2015

Det Norske Veritas, Non-

Profit, Opthalmology

1977

BUTLER

BOULEVAR

D

HOUSTO

N

TX 77030 713798

2305

HARRIS 1977

BUTLER

BOULEVAR

D

HOUSTO

N

TX 77030 5

CHILDREN

1ST DENTAL

& SURGERY

CENTER

1300

41

45C0001

175

05/31/2

020

05/13/

2010


Services

2690 N

GALLOWAY

AVENUE

MESQUIT

E TX 75150 972279

1200 DALLAS 2690 N

GALLOWAY

AVENUE

MESQUIT

E TX 75150 3

CHILDREN

1ST DENTAL

& SURGERY

CENTER

1301

88

04/30/2

020

04/24/

2014

AAAHC, For Profit, Oral 8545 GULF

FREEWAY

HOUSTO

N

TX 77017 713944

7700

HARRIS 8545 GULF

FREEWAY

HOUSTO

N

TX 77017 3

CHILDREN

1ST DENTAL

& SURGERY

CENTER

1302

02

09/30/2

020

09/03/

2014


Services

8700 S

GESSNER

DRIVE

SUITE 200

HOUSTO

N

TX 77074 713270

0700

HARRIS 3055 W

BARDIN

ROAD

#400

GRAND

PRAIRIE

TX 75052 3

16


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

CHILDREN

1ST GRAND

PRAIRIE LLC

1301

03

02/29/2

020

02/17/

2012


Services

3055 WEST

BARDIN

ROAD #

400

GRAND

PRAIRIE

TX 75052 214412

1500

DALLAS 3055 WEST

BARDIN

ROAD #

400

GRAND

PRAIRIE

TX 75052 3

CHILDRENS

PAVILION

SURGERY

CENTER

7908 453302 12/31/2

019

12/30/

2002




Services, Otolaryngology, Pain Management,

Plastic, Urology

2350

STEMMONS

FREEWAY

SUITE 100

DALLAS TX 75207 214456

1100

DALLAS 1935

MEDICAL

DISTRICT

C/O ADMINISTR

ATION

DALLAS TX 75235 8

CHRISTUS

GOOD

SHEPHERD

AMBULATOR

Y SURGICAL

CENTER

1303

68

08/31/2

019

02/20/

2018

Foot, Gastroenterology,


Non-Profit, OB/GYN,

Opthalmology, Oral,

Orthopedic,



Thoracic, Urology

703 EAST

MARSHALL

AVENUE

SUITE

2000

LONGVIE

W TX 75601 903315

5300 GREGG 703 EAST

MARSHALL

AVENUE

SUITE

2000

LONGVIE

W TX 75601 19

CHRISTUS

SANTA ROSA

PHYSICIAN ASC - STONE

OAK

8396 45C0001

440

09/30/2

020

09/19/

2006


For Profit, General,

OB/GYN, Opthalmology, Orthopedic,



Thoracic

502

MADISON

OAK DRIVE

SUITE 500

SAN

ANTONIO

TX 78258 210499

6700

BEXAR 100 NE

LOOP 410

SUITE 400

SAN

ANTONIO

TX 78216 7

CHRISTUS

SANTA ROSA

PHYSICIANS

AMBULATOR

Y SURGERY

CENTER-SAN

MAR

1302

85

45C0001

226

03/31/2

020

03/31/

2016


Gastroenterology

1305

WONDER

WORLD DR

SUITE 105

SAN

MARCOS

TX 78666 512353

8161

HAYS 1305

WONDER

WORLD DR

SUITE 105

SAN

MARCOS

TX 78666 2

CHRISTUS SANTA ROSA

PHYSICIANS

ASC - NEW

BRAUNFELS

1300

14

45C0001

365

07/31/2

021

07/02/

2009

AAAHC, Endoscopy, Foot, For Profit,

Gastroenterology,

General, OB/GYN,

Opthalmology, Oral,

Orthopedic,



Urology

1738 EAST COMMON

STREET

NEW BRAUNFE

LS

TX 78130 830643

8600

COMAL 1738 EAST COMMON

STREET

NEW BRAUNFE

LS

TX 78130 6

17


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

CHRISTUS

SPOHN

CORPUS

CHRISTI

OUTPATIENT

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7863 45C0001

245

07/31/2

020

07/30/

2002


For Profit,

Gastroenterology,

General, OB/GYN,

Orthopedic,


Management, Urology

3636

SOUTH

ALAMEDA

SUITE A

CORPUS

CHRISTI

TX 78411 361853

2200

NUECES 3636

SOUTH

ALAMEDA

SUITE A

CORPUS

CHRISTI

TX 78411 6

CHRISTUS SPOHN

SURGICARE

OF CORPUS

CHRISTI

8393 45C0001

250

08/31/2

020

09/01/

2006

For Profit, Gastroenterology, JC,

Opthalmology

718 ELIZABETH

STREET

CORPUS

CHRISTI

TX 78404 361882

3204

NUECES 718 ELIZABETH

STREET

CORPUS

CHRISTI

TX 78404 5

CHRISTUS

SURGERY

CENTER-

ALAMO

HEIGHTS

1304

30

04/30/2

021

04/12/

2019

Endoscopy, Foot,

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423

TREELINE

PARK

SUITE 202

SAN

ANTONIO

TX 78209 210949

6000

BEXAR 100 NE

LOOP 410

SUITE 475

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CHRISTUS SURGERY

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OLYMPIA

HILLS

1304

11

09/30/2

020

11/15/

2018

Foot, For Profit, Pain

Management

13525 CENTERBR

OOK SUITE

100

UNIVERS

AL CITY

TX 78148 210257

8039

BEXAR 13525 CENTERBR

OOK SUITE

100

UNIVERS

AL CITY

TX 78148 1

CHRISTUS

TRINITY

MOTHER

FRANCES

DEHAVEN

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CENTER-

TYLER

1304

01

45C0001

013

08/31/2

020

09/14/

2018

Non-Profit, Opthalmology 1424 EAST

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TYLER TX 75702 903595

4144

SMITH 1424 EAST

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CITYVIEW

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8142 45C0001

376

11/30/2

019

11/23/

2004 For Profit, Opthalmology 6551

HARRIS

PARKWAY,

SUITE 100

FORT

WORTH TX 76132 817781

5007 TARRANT 6551

HARRIS

PARKWAY,

SUITE 200

FORT

WORTH TX 76132 3

18


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

CLEARVIEW

SURGERY

CENTER INC

1300

86

45C0001

414

12/31/2

020

06/08/

2011

Non-Profit, Opthalmology 1980 EAST

STATE

HWY 114

SOUTHLA

KE

TX 76092 817329

2700

TARRANT 1980 EAST

STATE

HWY 114

SOUTHLA

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TX 76092 2

CLEBURNE

ENDOSCOPY

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1302

90

05/31/2

020

05/20/

2016



1701

WALTER

HOLLIDAY

DRIVE

SUITE 100

CLEBURN

E

TX 76033 817895

0095

JOHNSON 1701

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E

TX 76033 2

COASTAL

BEND AMBULATOR

Y SURGICAL

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147 45C0001

040

12/31/2

019

01/01/

1986


MORGAN

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CHRISTI

TX 78404 361888

4288

NUECES 900

MORGAN

CORPUS

CHRISTI

TX 78404 3

COLLEGE

PARK HEART

& VASCULAR

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1303

09

45C0001

613

11/30/2

020

11/17/

2016

Cardiovascular, For

Profit, JC

17183 I-45

SOUTH

SUITE 360

THE

WOODLA

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TX 77385 936321

0080

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17183 I-45

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THE

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COMFORT

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CENTER OF

SAN ANTONIO

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1304

19

01/31/2

021

01/16/

2019


Pain Management

1919

ROGERS

ROAD

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SAN

ANTONIO

TX 78251 210267

8000

BEXAR 1919

ROGERS

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SAN

ANTONIO

TX 78251 2

COMMUNITY

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8754

02/28/2

021

02/03/

2009




Opthalmology, Oral,

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Urology

3605

EXECUTIVE

DRIVE

SAN

ANGELO TX 76904 325223

0055

TOM

GREEN

3501

KNICKERB

OCKER

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SAN

ANGELO TX 76904 6

COMPLETE

SURGERY

HOUSTON

NORTHWEST

1304

06

10/31/2

020

10/05/

2018


OB/GYN, Orthopedic,


Management, Plastic

1900

NORTH

LOOP WEST

SUITE 600

HOUSTO

N

TX 77018 713461

3399

HARRIS 9434 KATY

FREEWAY

SUITE 408

HOUSTO

N

TX 77055 6

19


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

COOK

CHILDRENS

PEDIATRIC

SURGERY

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8189 45C0001

398

03/31/2

021

03/28/

2005

For Profit,

Gastroenterology,


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Urology

7000 WEST

PLANO

PARKWAY

SUITE 100

PLANO TX 75093 972300

0215

COLLIN 7000 WEST

PLANO

PARKWAY

SUITE 100

PLANO TX 75093 6

COOK

CHILDRENS

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CENTER LLC

1303

85

04/30/2

020

04/27/

2018



General, Opthalmology, Orthopedic, Other


Urology

6316

PRECINCT

LINE ROAD

SUITE B

HURST TX 76054 817605

2950

TARRANT 6316

PRECINCT

LINE ROAD

SUITE B

HURST TX 76054 5

COPPELL

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CENTER

1303

64

02/29/2

020

02/08/

2018

Foot, For Profit,

Gastroenterology,



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731 PLAZA

BOULEVAR

D

COPPELL TX 75019 469774

3081

DALLAS 731 PLAZA

BLVD

COPPELL TX 75019 3

CORM

SURGICENTE

R

1300

33

02/29/2

020

02/17/

2010

For Profit, OB/GYN, Other

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1015

MEDICAL

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BLVD

SUITE

2200

WEBSTER TX 77598 281332

0073

HARRIS 1015

MEDICAL

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BLVD

SUITE

2200

WEBSTER TX 77598 4

CORPUS

CHRISTI

ENDOSCOPY

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8573 45C0001

470

10/31/2

019

10/02/

2007


Other Services

6421

SARATOGA

BLVD

BUILDING

105

CORPUS

CHRISTI TX 78414 361985

9300 NUECES 6421

SARATOGA

BLVD

BUILDING

105

CORPUS

CHRISTI TX 78414 3

COVENANT

HIGH PLAINS

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22ND

STREET

1302

50

45C0001

441

07/31/2

021

07/31/

2015







Urology

3610 22ND

STREET

LUBBOCK TX 79410 806776

4772

LUBBOCK 3610 22ND

STREET

LUBBOCK TX 79410 5

20


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

COVENANT

HIGH PLAINS

SURGERY

CENTER -

QUAKER

AVENUE

1302

51

45C0001

045

07/31/2

021

07/31/

2015



Oral, Orthopedic,



Urology

2301

QUAKER

AVENUE

LUBBOCK TX 79410 806725

8801

LUBBOCK 2301

QUAKER

AVENUE

LUBBOCK TX 79410 9

CREEKSIDE

SURGERY

CENTER

1303

67

12/31/2

019

02/15/

2018


General, Opthalmology, Orthopedic, Other

Services, Pain

Management

10847

KUYKENDAHL ROAD

SUITE 150

THE

WOODLA

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TX 77382 281292

5620

MONTGO

MERY

10847

KUYKENDAHL ROAD

SUITE 150

THE

WOODLA

NDS

TX 77382 3

CRENSHAW

AMBULATOR

Y SURGICAL

CENTER

1303

16

45C0001

614

12/31/2

020

12/09/

2016


Management

5150

CRENSHAW

ROAD

SUITE

H100

PASADEN

A

TX 77505 832230

0836

HARRIS 5150

CRENSHAW

ROAD

SUITE

H100

PASADEN

A

TX 77505 2

CRYSTAL

OUTPATIENT

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1302

79

45C0001

608

02/29/2

020

02/09/

2016

AAAHC, For Profit,

General, OB/GYN,

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Services, Pain

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950

THREADNE

EDLE

STREET

SUITE 250

HOUSTO

N

TX 77079 713467

2453

HARRIS 950

THREADNE

EDLE

STREET

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HOUSTO

N

TX 77079 3

CRYSTAL OUTPATIENT

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CENTER LAKE

JACKSON

INC

269 45C0001

156

06/30/2

020

06/23/

1993

For Profit, Plastic 215 OAK DRIVE

SOUTH,

SUITE J

LAKE

JACKSON

TX 77566 979480

0105

BRAZORI

A

950 THREADNE

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SUITE 250

HOUSTO

N

TX 77079 2

CY FAIR

SURGERY

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7157 45C0001

160

03/31/2

020

03/02/

2000



General, OB/GYN,

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Management, Plastic

11250

FALLBROO

K DRIVE

HOUSTO

N

TX 77065 281955

7194

HARRIS 11250

FALLBROO

K DRIVE

HOUSTO

N

TX 77065 5

CYPRESSWO

OD SURGERY

CENTER LP

1302

11

11/30/2

020

11/25/

2014

For Profit, Pain

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9920

CYPRESSWOOD DRIVE

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HOUSTO

N

TX 77070 832953

2280

HARRIS 13406

MEDICAL COMPLEX

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TOMBALL TX 77375 1

21


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

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ROOMS

DALLAS DAY

SURGERY OF

TEXAS

NORTH LTD

8679 45C0001

495

08/31/2

020

08/06/

2008


NORTH

CENTRAL

EXPRESSW

AY

DALLAS TX 75231 214821

8613

DALLAS 9101

NORTH

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AY

DALLAS TX 75231 4

DALLAS

ENDOSCOPY

CENTER LTD

8262 45C0001

400

08/31/2

019

08/25/

2005


Gastroenterology, Other

Services

5327

NORTH

CENTRAL EXPRESSW

AY SUITE

200

DALLAS TX 75205 214520

8235

DALLAS 5327

NORTH

CENTRAL EXPRESSW

AY SUITE

200

DALLAS TX 75205 5

DALLAS IVF

SURGERY

CENTER LLC

1300

22

10/31/2

019

10/27/

2009

AAAHC, For Profit,

OB/GYN, Other Services

2840

LEGACY

DRIVE

SUITE 110

FRISCO TX 75034 214297

0022

COLLIN 2840

LEGACY

DRIVE

SUITE 100

FRISCO TX 75034 8

DALLAS

NEPHROLOG

Y

ASSOCIATES

VASCULAR

CENTER

DALLAS

1303

77

03/31/2

020

03/26/

2018

For Profit, Other Services 3604 LIVE

OAK SUITE

300

DALLAS TX 75204 214826

4224

DALLAS 3604 LIVE

OAK SUITE

300

DALLAS TX 75204 3

DALLAS

NEPHROLOG

Y

ASSOCIATES

VASCULAR

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PLANO

1303

56

11/30/2

019

11/17/

2017 For Profit, Other Services 4401

TRADITION

TRAIL

PLANO TX 75093 214579

6600 COLLIN 4401

TRADITION

TRAIL

PLANO TX 75093 2

DALLAS

SURGI

CENTER INC

188 45C0001

082

11/30/2

019

11/19/

1987


WALNUT

HILL LANE

SUITE 808

DALLAS TX 75231 214696

8828

DALLAS 8230

WALNUT

HILL LANE

SUITE 808

DALLAS TX 75231 6

DAY TIME

OUTPATIENT SURGERY

CENTER

7141 45C0001

272

12/31/2

019

12/21/

1999

Foot, For Profit, OB/GYN,

Orthopedic, Pain

Management, Urology

6311

SOUTHWEST BLVD

SUITE B

FORT

WORTH

TX 76132 817731

9400

TARRANT 6311

SOUTHWEST BLVD

SUITE B

FORT

WORTH

TX 76132 1

22


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

DERMATOLO

GY SURGERY

CENTER

1301

36

45C0001

328

12/31/2

020

12/31/

2012


Services

1367

DOMINION

PLAZA

TYLER TX 75703 903534

6200

SMITH 1367

DOMINION

PLAZA

TYLER TX 75703 4

DFW

CHILDRENS

SURGERY

CENTER LLC

1303

03

09/30/2

020

09/06/

2016


Services

5744 LBJ

FREEWAY

SUITE 200

DALLAS TX 75240 214613

5110

DALLAS 5744 LBJ

FREEWAY

SUITE 200

DALLAS TX 75240 2

DIGESTIVE

DISEASE

CENTER

1301

20

07/31/2

020

07/26/

2012



6400

FANNIN,

SUITE

1400

HOUSTO

N

TX 77030 713704

3450

HARRIS 909

FROSTWO

OD, SUITE

3:506.10

HOUSTO

N

TX 77024 6

DOCTORS

HOSPITAL AT

RENAISSANC

E LTD

OUTPATIENT

SURGICAL

CENTER

1302

54 450869 08/31/2

019

08/31/

2015




Oral, Orthopedic,

Otolaryngology, Urology

5520

LEONARDO

DA VINCE

EDINBUR

G TX 78539 956362

7360 HIDALGO 5501

SOUTH

MCCOLL

ROAD

EDINBUR

G TX 78539 18

DOCTORS

SURGERY

CENTER INC

295 45C0001

169

09/30/2

020

09/09/

1994

AAAHC, For Profit,

Opthalmology

5300

NORTH

STREET

NACOGD

OCHES

TX 75965 936569

8278

NACOGD

OCHES

5300

NORTH

STREET

NACOGD

OCHES

TX 75965 3

DOCTORS

UNITED

SURGERY

CENTER

1304

15

45C0001

077

12/31/2

020

12/21/

2018

Gastroenterology,

General, OB/GYN,

Opthalmology, Orthopedic, Other

Services, Pain


Urology

5146

PRESTON

AVENUE

PASADEN

A

TX 77505 713947

0330

HARRIS 15305

DALLAS

PARKWAY SUITE

1600

ADDISON TX 75001 12

DODSON

SURGERY

CENTER

1301

08

03/31/2

020

03/14/

2012

Endoscopy,

Gastroenterology,





Pain Management,

Plastic, Urology

1500

COOPER ST

FORT

WORTH

TX 76104 682885

4340

TARRANT 801

SEVENTH

AVE

FORT

WORTH

TX 76104 6

23


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

DOMAIN

SURGICAL

LLC

1304

29

04/30/2

021

04/08/

2019

Foot, For Profit, Oral,


Management, Plastic

2300

WOLFLIN

AVENUE

AMARILL

O

TX 79109 806350

5437

2455 1-40

WEST

AMARILL

O

TX 79109 2

DOVE

POINTE

SURGERY

CENTER

390 45C0001

249

09/30/2

021

09/17/

1998

For Profit, Orthopedic 5520

NORTH C

STREET

MCALLEN TX 78504 956686

5788

HIDALGO 5520

NORTH C

STREET

MCALLEN TX 78504 2

EAST EL

PASO

SURGERY

CENTER

7329 45C0001

126

06/30/2

020

06/13/

2001


General, OB/GYN,

Opthalmology, Oral, Otolaryngology, Pain


Urology

7835

CORRAL

DRIVE

EL PASO TX 79915 915595

3353

EL PASO 7835

CORRAL

DRIVE

EL PASO TX 79915 4

EAST TEXAS

EYE

ASSOCIATES

SURGERY

CENTER

210 45C0001

097

10/31/2

019

10/04/

1988

For Profit, Opthalmology 1306 WEST

FRANK

AVENUE

LUFKIN TX 75904 936634

8381

ANGELIN

A

1306 WEST

FRANK

AVENUE

LUFKIN TX 75904 3

EASTSIDE

SURGERY

CENTER

7237 451192 10/31/2

020

10/25/

2000

For Profit,

Gastroenterology,

General, Orthopedic, Pain

Management

10918

EAST

FREEWAY

HOUSTO

N

TX 77029 713451

4299

HARRIS 10918

EAST

FREEWAY

HOUSTO

N

TX 77029 3

ECLIPSE

SURGICARE

LLC

1301

56

45C0001

548

08/31/2

021

08/26/

2013


Management

461

WESTPARK

WAY

EULESS TX 76040 817553

3627

TARRANT 6620

COLLEYVILLE BLVD

STE 100

COLLEYVI

LLE

TX 76034 2

EL PASO

CENTER FOR

GASTROINTE

STINAL

ENDOSCOPY

LLC

8549 45C0001

465

08/31/2

021

08/23/

2007



Pain Management

1620

NORTH

MESA

EL PASO TX 79902 915545

5300

EL PASO 1620

NORTH

MESA

EL PASO TX 79902 4

24


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

EL PASO DAY

SURGERY

8139 45C0001

374

11/30/2

020

11/15/

2004

AAAHC, For Profit,

General, OB/GYN,

Opthalmology,

Orthopedic,



Urology

1300

MURCHISO

N SUITE

200

EL PASO TX 79902 915594

9333

EL PASO 1300

MURCHISO

N SUITE

200

EL PASO TX 79902 6

ELITE MINIMALLY

INVASIVE

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OAKBEND

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1302

46

04/30/2

021

05/01/

2015

Endoscopy, Foot, Neurological, Non-Profit,

Orthopedic, Other


Pain Management

6655 TRAVIS

STREET

SUITE 200

HOUSTO

N

TX 77030 713595

5900

HARRIS 6655 TRAVIS

STREET

SUITE 200

HOUSTO

N

TX 77030 6

ELM PLACE

AMBULATOR

Y SURGICAL

CENTER

166 45C0001

065

11/30/2

019

11/05/

1986

For Profit, Otolaryngology 2217

SOUTH

DANVILLE

DRIVE

ABILENE TX 79605 325695

0600

TAYLOR 2217

SOUTH

DANVILLE

DRIVE

ABILENE TX 79605 2

ENDOSCOPY

CENTER AT

CENTRAL

PARK

7784 45C0001

291

08/31/2

021

08/21/

2001


Profit

1600

CENTRAL

DRIVE

SUITE 300

BEDFORD TX 76022 817318

0235

TARRANT 1A

BURTON

HILLS BOULEVAR

D ATTN

L&C

NASHVIL

LE

TN 37215 3

ENDOSCOPY

CENTER AT

MED POINT

7963 45C0001

339

06/30/2

020

06/30/

2003

AAAHC, For Profit,

Gastroenterology

1200 EAST

SAVANNAH

AVENUE

SUITE 15

MCALLEN TX 78503 956687

2673

HIDALGO 1200 EAST

SAVANNAH

AVENUE

SUITE 15

MCALLEN TX 78503 8

ENDOSCOPY

CENTER AT

REDBIRD

SQUARE

7032 45C0001

255

06/30/2

021

06/30/

1999



3107 WEST

CAMP

WISDOM

ROAD

SUITE 189

DALLAS TX 75237 214331

2922

DALLAS 1A

BURTON

HILLS

BLVD.

ATTN: L&C

NASHVIL

LE

TN 37215 3

ENDOSCOPY

CENTER OF

EL PASO

404 45C0001

242

12/31/2

019

12/10/

1998

AAAHC, For Profit,

Gastroenterology

1300

MURCHISON DRIVE

SUITE 180

EL PASO TX 79902 915544

5000

EL PASO 1 A

BURTON HILLS

BLVD

NASHVIL

LE

TN 37215 4

25


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

ENDOSCOPY

CENTER OF

SOUTHEAST

TEXAS

8331 45C0001

170

02/29/2

020

02/28/

2006


Gastroenterology

950 NORTH

14TH

STREET

SUITE 200

BEAUMO

NT

TX 77702 409833

5555

JEFFERSO

N

1A

BURTON

HILLS

BLVD ATTN

L AND C

NASHVIL

LE

TN 37215 5

EVERGREEN

SURGICAL

CENTER LLC

1304

38

05/31/2

021

06/18/

2019


Other Services,


Management

9303 NEW

TRAILS

DRIVE

SPRING TX 77381 346413

6040

MONTGO

MERY

9303 NEW

TRAILS

DRIVE

SUITE 180

SPRING TX 77381 3

EXECUTIVE SURGERY

CENTER

1301

70

45C0001

555

12/31/2

019

12/12/

2013

AAAHC, Foot, For Profit, Orthopedic, Pain


Urology

13603 MICHEL

ROAD

TOMBALL TX 77375 832698

3720

HARRIS 13603 MICHEL

ROAD

TOMBALL TX 77375 4

EYE 35 ASC

LLC

1303

59

01/31/2

020

01/03/

2018

For Profit, Opthalmology 17005 IH

35 N SUITE

2

SCHERTZ TX 78154 210614

3600

GUADALU

PE

17005 IH

35 N SUITE

2

SCHERTZ TX 78154 2

EYE

SURGERY

CENTER OF

EAST TEXAS

PLLC

1303

51

10/31/2

019

10/18/

2017

For Profit, Opthalmology 2448 EAST

5TH

STREET

TYLER TX 75701 903595

0500

SMITH 2440 EAST

5TH

STREET

TYLER TX 75701 5

EYE

SURGERY

CENTER OF NORTH

DALLAS

1302

01

45C0001

563

08/31/2

020

08/22/

2014

For Profit, JC,

Opthalmology

3100 E

TRINITY

MILLS

ROAD

CARROLL

TON

TX 75006 972380

2020

DALLAS 3100 E

TRINITY

MILLS

ROAD

CARROLL

TON

TX 75006 6

FACIAL

PLASTIC &

COSMETIC

SURGICAL

CENTER

111 45C0001

030

12/31/2

019

01/01/

1986

For Profit, Other Services 6300

REGIONAL

PLAZA

SUITE 475

ABILENE TX 79606 325695

3630

TAYLOR 6300

REGIONAL

PLAZA

SUITE 475

ABILENE TX 79606 4

FAITH

SURGICAL

CENTER

1302

37

10/31/2

020

10/22/

2014





Orthopedic, Pain

Management, Plastic

3716

STANDRID

GE DRIVE

SUITE 100

THE

COLONY

TX 75056 972370

7200

DENTON 3716

STANDRID

GE DRIVE

SUITE 100

THE

COLONY

TX 75056 3

26


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

FANNIN

SURGICARE

8259 45C0001

409

08/31/2

019

08/22/

2005



General, OB/GYN,

Otolaryngology, Plastic,

Urology

7700

FANNIN

STREET

HOUSTO

N

TX 77054 713796

3800

HARRIS 7700

FANNIN

STREET

HOUSTO

N

TX 77054 7

FIRST

COLONY

SURGERY

CENTER LLC

1303

20

12/31/2

020

12/27/

2016


Management

600

FERRIS

AVENUE

SUITE B

WAXAHA

CHIE

TX 75165 972497

2290

ELLIS 5520 LBJ

FREEWAY

SUITE 100

DALLAS TX 75240 3

FIRST NOBILIS

SURGICAL

CENTER

1302

07

09/30/2

020

10/14/

2014

Foot, For Profit, Gastroenterology,

General, Orthopedic,

Plastic

411 NORTH FIRST

STREET

BELLAIRE TX 77401 713665

1111

HARRIS 411 NORTH FIRST

STREET

BELLAIRE TX 77401 6

FIRST

SURGERY

SUITES LLC

1300

30

45C0001

504

02/29/2

020

02/03/

2010


Gastroenterology,

General, OB/GYN, Oral,

Orthopedic,


Management, Urology

1402

MEDICAL

DRIVE

SULPHUR

SPRINGS

TX 75482 903885

7474

HOPKINS 1402

MEDICAL

DRIVE

SULPHUR

SPRINGS

TX 75482 6

FISH POND

SURGERY

CENTER

8750 45C0001

276

01/31/2

021

01/20/

2009



Oral, Orthopedic, Other Services, Otolaryngology,

Pain Management,

Plastic, Urology

601 WEST

HWY 6

SUITE 109

WACO TX 76710 254751

9836

MCLENNA

N

601 WEST

HWY 6

SUITE 109

WACO TX 76710 6

FORT BEND

SURGERY

CENTER OF

OAKBEND

HEALTH

SYSTEM

1303

07

450330 10/31/2

020

10/15/

2016

Endoscopy, Foot,

Gastroenterology,

General, JC, Non-Profit,

Orthopedic, Other

Services, Pain

Management, Plastic

14851

SOUTHWES

T FREEWAY

SUGAR

LAND

TX 77478 281313

7300

FORT

BEND

14851

SOUTHWES

T FREEWAY

SUGAR

LAND

TX 77478 3

FORT WORTH

ENDOSCOPY

CENTER

8397 45C0001

180

09/30/2

020

09/19/

2006

For Profit,

Gastroenterology

900 WEST

MAGNOLIA

AVENUE

SUITE 101

FORT

WORTH

TX 76104 817332

6500

TARRANT 900 WEST

MAGNOLIA

AVENUE

SUITE 101

FORT

WORTH

TX 76104 4

27


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

MAIL

ING

STAT

E

MAILI

NG

ZIP

SURGERY

SUITES/PRO

CEDURE

ROOMS

FRISCO

AMBULATOR

Y SURGERY

CENTER

1301

80

45C0001

571

12/31/2

019

02/25/

2014

AAAHC, For Profit,

Neurological, Orthopedic,


Management, Urology

5616

WARREN

PARKWAY

SUITE

#100

FRISCO TX 75034 972712

4800

COLLIN 5616

WARREN

PARKWAY

SUITE

#100

FRISCO TX 75034 2

FRISCO

FIRST

SURGERY

CENTER

1304

22

01/31/2

021

01/29/

2019


Orthopedic, Pain

Management

8740 OHIO

DRIVE

SUITE B-1

PLANO TX 75024 972943

6220

COLLIN 3118 FM

528 #167

WEBSTER TX 77598 2

GAB ENDOSCOPY

CENTER LTD

7994 45C0001

345

10/31/2

019

10/20/

2003

For Profit,


621 CAMDEN

STREET

#102

SAN

ANTONIO

TX 78215 210253

3430

BEXAR 621 CAMDEN

STREET

#102

SAN

ANTONIO

TX 78215 2

GASTROENTE

ROLOGY

CONSULTANT

S OF SAN

ANTONIO -

NE

1301

92

45C0001

567

06/30/2

020

06/18/

2014



12850

TOEPPERW

EIN ROAD

LIVE OAK TX 78233 210614

1234

BEXAR PRIVATE

4

GASTROENTE

ROLOGY

CONSULTANTS OF SAN

ANTONIO -

STONE OAK

1301

39

45C0001

477

12/31/2

020

02/01/

2013



855

PROTON

ROAD

SAN

ANTONIO

TX 78258 210614

1234

BEXAR 8415

DATAPOIN

T SUITE

700

SAN

ANTONIO

TX 78229 4

GASTROENTE

ROLOGY

CONSULTANT

S OF SAN

ANTONIO-

MEDICAL

CENTER

1303

25

03/31/2

021

03/16/

2017

AAAHC, For Profit,

Gastroenterology

5223

HAMILTON

WOLFE

SAN

ANTONIO

TX 78229 210614

1234

BEXAR 8415

DATAPOIN

T #700

SAN

ANTONIO

TX 78229 6

GASTROINTE

STINAL

ENDOSCOPY

CENTER

8151 45C0001

168

12/31/2

019

12/01/

2004

For Profit,

Gastroenterology

1600 COIT

ROAD

SUITE

401A

PLANO TX 75075 972612

9771

COLLIN 1600 COIT

ROAD

SUITE

401A

PLANO TX 75075

-6173

2

28


NAME

LICE

NSE

NUM

BER CCN

EXPIRA

TION

EFFEC

TIVE

SERVICES/ACCREDITA


STA

TE ZIP PHONE COUNTY

MAILING

ADDRESS

MAILIN

G CITY

Documents

Health and Human Services Commission - Texas · 2019-09-11 · texas health and human services hhs.texas.gov name lice nse num ber ccn expira tion effec tive services/accredita tion/status