Select ASC Developers of Southlake, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SELECT ASC DEVELOPERS OF SOUTHLAKE, LLC

Practice address

3065 W Southlake Blvd
Southlake, TX 76092-6730

Phone

(972) 234-4740

NPI assigned

Apr 19, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Tracy Walls

Title

President

Phone

(972) 234-4740

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1033643747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674201",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674201",
            "telephone_number": "972-234-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 W SOUTHLAKE BLVD",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926730",
            "telephone_number": "972-234-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT ASC DEVELOPERS OF SOUTHLAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-234-4740",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SDG Physicians Group PA
• Carrie Cole Seale
• Julie A. Seeber, PTA
• Seek Health LLC
• Shannon Selbo, PA-C
• Select Physical Therapy Texas Limited Partnership
• Janetta Serano
• Makayla Nicole Settle, OTR
• Makena Sewell
• Robert W Sewell, MD

• Ambulatory Surgical Clinic/Center in Southlake, TX
• Providers in Southlake, 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 Apr 19, 2017; 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.