Killeen Surgical Operating Company, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

KILLEEN SURGICAL OPERATING COMPANY, LLC

Practice address

3400 E Central Texas Expy Ste 100
Killeen, TX 76543-7325

Phone

(254) 246-4761

Fax

(254) 246-4762

NPI assigned

Sep 7, 2022

Organization subpart

No

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

Authorized official

Name

Kisha Moore

Title

Sr ASC Administrator

Phone

(512) 341-2273

Specialties & licenses 1

Addresses

Other names 1

• Advanced Surgical Center - Killeen Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Killeen Surgical Operating Company LLC Dba Advanced Surgical Center KilleenCCN 45C0451266

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1235850397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W LOUIS HENNA BLVD STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787281203",
            "telephone_number": "512-244-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 E CENTRAL TEXAS EXPY STE 100",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765437325",
            "telephone_number": "254-246-4761",
            "fax_number": "254-246-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILLEEN SURGICAL OPERATING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KISHA",
        "authorized_official_title_or_position": "SR ASC ADMINISTRATOR",
        "authorized_official_telephone_number": "512-341-2273"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Surgical Center - Killeen",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Surgical Center - Killeen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Killeen Medical Clinic , P.a.
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• Killeen Pediatric Care Clinic, P.a.
• Killeen Pharmacy
• Killeen Vision 153
• Tae Won Kim, O.D.
• Amanda Rose Kimball
• Dominique Kimble, NP
• Lindsey Grace Julliette Kimbrough, RD/RDN, LD

• Ambulatory Surgical Clinic/Center in Killeen, TX
• Providers in Killeen, 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 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.