NPIMap

Organization Active NPI

Willow Creek Surgery Center LP

  • Ambulatory Surgical Clinic/Center
  • Palestine, TX
National Provider Identifier
1699006254
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
WILLOW CREEK SURGERY CENTER LP
Practice address
300 Willow Creek Pkwy
Suite 100
Palestine, TX 75801-4389
Phone
(417) 889-2040
Fax
(417) 887-2935
NPI assigned
Jan 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Authorized official

Name
Vernescia Fuller
Title
Office Manager
Phone
(903) 729-2888

Specialties & licenses 1

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

Addresses

Primary practice location

300 Willow Creek Pkwy
Suite 100
Palestine, TX 75801-4389

Mailing address

300 Willow Creek Pkwy
Suite 100
Palestine, TX 75801-4389
Phone (417) 889-2040

National Provider Directory

National Provider Directory

Locations

300 Willow Creek Pkwy
Ste 100
Palestine, TX 75801
Phone (469) 436-3650

Practitioners & affiliated clinicians

Practitioners 1

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": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1699006254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WILLOW CREEK PKWY",
            "address_2": "SUITE 100",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014389",
            "telephone_number": "417-889-2040",
            "fax_number": "417-887-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WILLOW CREEK PKWY",
            "address_2": "SUITE 100",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014389",
            "telephone_number": "417-889-2040",
            "fax_number": "417-887-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK SURGERY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "VERNESCIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "903-729-2888"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.