Provider Demographics
NPI:1609814508
Name:OUTPATIENT ORTHOPAEDIC ASSOCIATES SURGERY CENTER LLC
Entity Type:Organization
Organization Name:OUTPATIENT ORTHOPAEDIC ASSOCIATES SURGERY CENTER LLC
Other - Org Name:OUTPATIENT SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-1283
Mailing Address - Street 1:20 BURTON HILLS BLVD.
Mailing Address - Street 2:SUITE 500
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6176
Mailing Address - Country:US
Mailing Address - Phone:615-665-1283
Mailing Address - Fax:615-665-0755
Practice Address - Street 1:1505 HARROUN STREET
Practice Address - Street 2:SUITE #1
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3433
Practice Address - Country:US
Practice Address - Phone:972-562-5745
Practice Address - Fax:972-562-5976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007945261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH011AOtherBLUE CROSS BLUE SHIELD
ASC179Medicare PIN
45C0001332Medicare Oscar/Certification