Texas Health Surgery Center Willow Park LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

TEXAS HEALTH SURGERY CENTER WILLOW PARK LLC

Practice address

120 Jimma Dr
Willow Park, TX 76087-1330

Phone

(833) 839-0007

NPI assigned

May 10, 2022

Organization subpart

No

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

Authorized official

Name

Tracy Camp

Title

Ceo

Phone

(940) 230-3449

Specialties & licenses 1

Addresses

Other names 1

• Texas Health Orthopedic and Spine Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Texas Health Surgery Center Willow Park LLC Dba Texas Health Orthopedic and Spine Surgery CenterCCN 45C0451260

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

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1407592769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 JIMMA DR",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760871330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 JIMMA DR",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760871330",
            "telephone_number": "833-839-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS HEALTH SURGERY CENTER WILLOW PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-10",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "CAMP",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-230-3449"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Health Orthopedic and Spine Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia Beth Talboys, FNP-C
• Richard Steven Taylor, LPC, LMSW
• Texas Grins Family Dentistry, PA
• Texas Health Care, P.L.L.C.
• Texas Health Care, PLLC
• Kailey Thompson
• Thrive Behavior Centers LLC
• Lauren Timms
• Tom Annunziato, OD PC
• Alexandria Tort

• Ambulatory Surgical Clinic/Center in Willow Park, TX
• Providers in Willow Park, 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 Oct 31, 2023; 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.