Permian Basin Surgical Care Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

007919 Issued in TX

Legal business name

PERMIAN BASIN SURGICAL CARE CENTER, LLC

Doing business as

Vista Surgery Center

Practice address

4200 Andrews Hwy
Midland, TX 79703

Phone

(432) 520-5888

Fax

(432) 520-5889

NPI assigned

Aug 19, 2006

Last updated

Mar 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jennifer B. Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5900

Specialties & licenses 1

Addresses

Other names 1

• Vista Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Permian Basin Surgical Care CenterCCN 45C0001165

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": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1275647901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 ANDREWS HWY",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034822",
            "telephone_number": "432-520-5888",
            "fax_number": "432-520-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 ANDREWS HWY",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "79703",
            "telephone_number": "432-520-5888",
            "fax_number": "432-520-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERMIAN BASIN SURGICAL CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "007919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vista Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Permian Basin ER II (Excel ER)
• Permian Basin Eye Care Center Inc (Texas Country Eye Care)
• Permian Basin Facial and Reconstructive Surgery
• Permian Basin Senior Care, LLC (Home Instead Senior Care)
• Permian Basin Speech Language and Learning Services Inc
• Permian Basin Urology Center L.P. (Daniel Khouri MD)
• Permian Basin Wound Care Specialists, PLLC
• Permian Cardiology Associates
• Permian Cardiology, Inc.
• Permian Diagnostics PLLC

• Ambulatory Surgical Clinic/Center in Midland, TX
• Providers in Midland, 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 Mar 25, 2022; 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.