Select Ambulatory Surgery Center of Ft Worth LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SELECT AMBULATORY SURGERY CENTER OF FT WORTH LLC

Practice address

2001 Cooper St
Ft Worth, TX 76104-2529

Phone

(817) 334-0990

NPI assigned

Oct 7, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristy McGill

Title

Director of Network Development

Phone

(972) 215-7410

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1033589742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674394",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674394",
            "telephone_number": "972-479-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 COOPER ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761042529",
            "telephone_number": "817-334-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT AMBULATORY SURGERY CENTER OF FT WORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "MCGILL",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "DIRECTOR OF NETWORK DEVELOPMENT",
        "authorized_official_telephone_number": "972-215-7410"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "130265",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Blaine Sekpe, M.D.
• Austin Ross Sekula
• Mackenzie Selby, PA-C
• Samuel Thomas Selby, D.O.
• Stacey Selby, M.ED., LPC
• Select Physical Therapy Holdings, Inc.
• Select Physical Therapy Texas Limited Partnership
• Self Richard Dba
• Angela Donna Self, MD
• Kinzi Lea Self, APRN, AGACNP-BC

• Ambulatory Surgical Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.