Organization Active NPI

Tyler TX ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Tyler, TX
National Provider Identifier
1689353823
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
TYLER TX ASC LLC
Practice address
4801 Troup Hwy Ste 800
Tyler, TX 75703-2357
Phone
(903) 202-0595
NPI assigned
Jul 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Authorized official

Name
Erica Hardy
Title
VP, HR & Compliance
Phone
(903) 363-1558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

4801 Troup Hwy Ste 800
Tyler, TX 75703-2357

Mailing address

4801 Troup Hwy Ste 800
Tyler, TX 75703-2357
Phone (902) 202-0595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231024000069 TX Part B Supplier - Ambulatory Surgical Center 5193171429 Practice locations: Tyler, TX

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Tyler TX ASC LLC Dba Tyler Surgery CenterCCN 45C0451298
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2289512Tyler TX ASC, LLC4801 Troup Hwy, Suite 800, Tyler, TX 75703Certificate of waiverSep 11, 2027

National Provider Directory

National Provider Directory

Locations

4801 Troup Hwy
Ste 800
Tyler, TX 75703
Phone (903) 363-1558

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1689353823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 TROUP HWY STE 800",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032357",
            "telephone_number": "902-202-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 TROUP HWY STE 800",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032357",
            "telephone_number": "903-202-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER TX ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-14",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "VP, HR & COMPLIANCE",
        "authorized_official_telephone_number": "903-363-1558"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.