Urological Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

UROLOGICAL SURGERY CENTER LLC

Practice address

418 S Henderson St
Fort Worth, TX 76104-1017

Phone

(817) 870-9165

Fax

(817) 870-9165

NPI assigned

Aug 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles Bamberger, DIRECTOR

Title

Director

Phone

(817) 229-4222

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 45C0001143

Legal name

UROLOGICAL SURGERY CTR OF FORT WORTH

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 17, 1992

Last certification

Aug 11, 2015

Ownership / control type

Proprietary

Facility address

418 S Henderson
Fort Worth, TX 76104

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1700994290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1958",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76101",
            "telephone_number": "817-229-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761041017",
            "telephone_number": "817-870-9165",
            "fax_number": "817-870-9165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGICAL SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BAMBERGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-229-4222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085925801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Norma Urbina
• Valeria Urbina, MD
• Raisa Urias
• Alexis Dominique Uribe, DO
• Irma Villanueva Uribe, RDH,BS
• Urology Consultants of Fort Worth LLP
• Urolux Concierge LLC
• Andrew Urquhart
• Robert L Ursprung, M.D.
• US Dental Professionals Anderson PLLC

• Ambulatory Surgical Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, 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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.