profession roster report - texas health and human services · 2021. 6. 15. · el paso, tx 79925...

39
License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL Profession Roster Report Order By Name Ambulatory Surgical Center LIC# Selected Address(MA) Phone Status/Secondary Status Expires Rank Date Status Date Orig. Date Name ABILENE CATARACT & REFRACTIVE SURGERY CENTER 000353 3256952020 2120 ANTILLEY ROAD 02/28/2022 08/31/1987 08/31/1987 02/14/2008 Current ABILENE, TX 79606 ABILENE CENTER FOR ORTHOPEDIC AND MULTISPECIALTY SURGERY,LLC 130397 3252328110 6449 CENTRAL PARK BLVD 07/31/2022 07/31/2018 07/31/2018 07/31/2018 Current ABILENE, TX 79606 ABILENE ENDOSCOPY CENTER 000301 3256772626 1249 AMBLER AVENUE SUITE 100 12/31/2021 12/06/1994 12/06/1994 11/13/2007 Current ABILENE, TX 79601 ABILENE SPINE & JOINT SURGERY CENTER LLC 130494 3257951888 4351 RIDGEMONT DR STE B 09/30/2022 09/01/2020 09/01/2020 09/01/2020 Current ABILENE, TX 79606 ABILENE SURGERY CENTER LLC 130000 3256904466 5601 HEALTH CENTER DRIVE 03/31/2023 03/11/2009 03/11/2009 01/15/2021 Current ABILENE, TX 79606 ABILENE WHITE ROCK SURGERY CENTER, LLC 130269 3256767700 2401 N TREADAWAY BOULEVARD 12/31/2021 12/01/2015 12/01/2015 12/01/2015 Current ABILENE, TX 79604 ACPS - THE SURGICENTRE 130330 7137999999 12727 KIMBERLEY LANE SUITE 100 04/30/2023 04/28/2017 04/28/2017 04/28/2017 Current HOUSTON, TX 77024 ACUTE AND CHRONIC PAIN MANAGEMENT CENTER 007835 8063536100 24 CARE CIRCLE 03/31/2022 03/25/2002 03/25/2002 02/19/2020 Current AMARILLO, TX 79124 ADC ENDOSCOPY SPECIALISTS 008375 8063531769 1 CARE CIRCLE 06/30/2022 06/22/2006 06/22/2006 05/13/2008 Current AMARILLO, TX 79124 ADVANCED CARDIOVASCULAR SURGERY CENTER AT METHODIST WEST HOUSTON 130311 2818292226 18400 KATY FREEWAY SUITE 330 11/30/2022 11/28/2016 11/28/2016 11/28/2016 Current HOUSTON, TX 77094 ADVANCED SURGERY CENTER OF SAN ANTONIO LLC 130216 2104554150 18414 US HIGHWAY 281 NORTH SUITE 114 01/31/2023 01/09/2015 01/09/2015 01/12/2015 Current SAN ANTONIO, TX 78259-7611 ADVANCED SURGICAL CARE OF BOERNE LLC 130370 8304283166 138 OLD SAN ANTONIO ROAD #400 02/28/2022 02/21/2018 02/21/2018 02/21/2018 Current BOERNE, TX 78006 ADVANCED SURGICAL CENTER - AMARILLO 130404 8065134677 1901 MEDI- PARK BUILDING C SUITE 1 09/30/2022 09/25/2018 09/25/2018 09/22/2020 Current AMARILLO, TX 79106 ADVANCED SURGICAL CENTER - ROUND ROCK 130009 5123412273 2000 SOUTH MAYS STREET SUITE 400 04/30/2023 04/27/2009 04/27/2009 03/16/2021 Current ROUND ROCK, TX 78664 Page 1 of 39 6/9/2021

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Page 1: Profession Roster Report - Texas Health and Human Services · 2021. 6. 15. · el paso, tx 79925 130176 bay area endoscopy 444 fm 1959 suite b 2814819400 12/31/2021 12/31/2013 02/12/2014

License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

ABILENE CATARACT & REFRACTIVE

SURGERY CENTER

000353 32569520202120 ANTILLEY ROAD 02/28/2022 08/31/1987 08/31/1987 02/14/2008 Current

ABILENE, TX 79606

ABILENE CENTER FOR ORTHOPEDIC

AND MULTISPECIALTY SURGERY,LLC

130397 32523281106449 CENTRAL PARK BLVD 07/31/2022 07/31/2018 07/31/2018 07/31/2018 Current

ABILENE, TX 79606

ABILENE ENDOSCOPY CENTER000301 32567726261249 AMBLER AVENUE SUITE 100 12/31/2021 12/06/1994 12/06/1994 11/13/2007 Current

ABILENE, TX 79601

ABILENE SPINE & JOINT SURGERY

CENTER LLC

130494 32579518884351 RIDGEMONT DR STE B 09/30/2022 09/01/2020 09/01/2020 09/01/2020 Current

ABILENE, TX 79606

ABILENE SURGERY CENTER LLC130000 32569044665601 HEALTH CENTER DRIVE 03/31/2023 03/11/2009 03/11/2009 01/15/2021 Current

ABILENE, TX 79606

ABILENE WHITE ROCK SURGERY

CENTER, LLC

130269 32567677002401 N TREADAWAY BOULEVARD 12/31/2021 12/01/2015 12/01/2015 12/01/2015 Current

ABILENE, TX 79604

ACPS - THE SURGICENTRE130330 713799999912727 KIMBERLEY LANE SUITE 100 04/30/2023 04/28/2017 04/28/2017 04/28/2017 Current

HOUSTON, TX 77024

ACUTE AND CHRONIC PAIN

MANAGEMENT CENTER

007835 806353610024 CARE CIRCLE 03/31/2022 03/25/2002 03/25/2002 02/19/2020 Current

AMARILLO, TX 79124

ADC ENDOSCOPY SPECIALISTS008375 80635317691 CARE CIRCLE 06/30/2022 06/22/2006 06/22/2006 05/13/2008 Current

AMARILLO, TX 79124

ADVANCED CARDIOVASCULAR

SURGERY CENTER AT METHODIST

WEST HOUSTON

130311 281829222618400 KATY FREEWAY SUITE 330 11/30/2022 11/28/2016 11/28/2016 11/28/2016 Current

HOUSTON, TX 77094

ADVANCED SURGERY CENTER OF SAN

ANTONIO LLC

130216 210455415018414 US HIGHWAY 281 NORTH SUITE

114

01/31/2023 01/09/2015 01/09/2015 01/12/2015 Current

SAN ANTONIO, TX 78259-7611

ADVANCED SURGICAL CARE OF

BOERNE LLC

130370 8304283166138 OLD SAN ANTONIO ROAD #400 02/28/2022 02/21/2018 02/21/2018 02/21/2018 Current

BOERNE, TX 78006

ADVANCED SURGICAL CENTER -

AMARILLO

130404 80651346771901 MEDI- PARK BUILDING C SUITE 1 09/30/2022 09/25/2018 09/25/2018 09/22/2020 Current

AMARILLO, TX 79106

ADVANCED SURGICAL CENTER -

ROUND ROCK

130009 51234122732000 SOUTH MAYS STREET SUITE 400 04/30/2023 04/27/2009 04/27/2009 03/16/2021 Current

ROUND ROCK, TX 78664

Page 1 of 396/9/2021

Page 2: Profession Roster Report - Texas Health and Human Services · 2021. 6. 15. · el paso, tx 79925 130176 bay area endoscopy 444 fm 1959 suite b 2814819400 12/31/2021 12/31/2013 02/12/2014

License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

ADVANCED SURGICAL CENTER LLC130304 46990488881018 E WHEATLAND ROAD 09/30/2022 09/06/2016 09/06/2016 09/06/2016 Current

DUNCANVILLE, TX 75116

ALAMO CITY SURGERY CENTER PLLC130238 21061447427402 JOHN SMITH DRIVE SUITE 104 05/31/2023 05/22/2015 05/22/2015 06/03/2016 Current

SAN ANTONIO, TX 78229

ALPHA SURGICAL CENTER130451 346336780024727 TOMBALL PARKWAY SUITE 100 11/30/2021 11/15/2019 11/15/2019 11/15/2019 Current

TOMBALL, TX 77375

ALTUS BAYTOWN HOSPITAL130517 2814228818720 1/2 ROLLINGBROOK DR 09/30/2022 09/11/2020 09/11/2020 12/21/2020 Current

BAYTOWN, TX 77521

AMARILLO CATARACT AND EYE

SURGERY CENTER LTD

006946 80635488917310 FLEMING AVENUE 12/31/2022 01/01/1999 01/01/1999 12/07/2010 Current

AMARILLO, TX 79106

AMARILLO COLONOSCOPY CENTER LP130091 8063678537800 QUAIL CREEK DRIVE SUITE 102 09/30/2021 09/09/2011 09/09/2011 09/09/2011 Current

AMARILLO, TX 79124

AMARILLO ENDOSCOPY CENTER007790 80646798206833 PLUM CREEK 09/30/2021 09/25/2001 09/25/2001 09/04/2007 Current

AMARILLO, TX 79124

AMBULATORY SURGICAL INSTITUTE

OF DALLAS, LLC

130152 972234474017051 DALLAS PARKWAY, SUITE 100 07/31/2023 07/11/2013 07/11/2013 07/12/2013 Current

ADDISON, TX 75001

AMERICAN SURGERY CENTER130435 210692021812838 VISTA DEL NORTE 05/31/2023 05/22/2019 05/22/2019 05/22/2019 Current

SAN ANTONIO, TX 78216

ASC CENTER FOR CHANGE LLC130048 2814191123119 VISION PARK BOULEVARD 07/31/2022 07/02/2010 07/02/2010 07/02/2010 Current

SHENANDOAH, TX 77384

ASCENT SURGERY CENTER130483 46998637006957 WEST PLANO PKWY SUITE 1000 05/31/2022 05/22/2020 05/22/2020 05/22/2020 Current

PLANO, TX 75093

AUA SURGICAL CENTER LLC130244 80635073888207 WEST AMARILLO BOULEVARD 07/31/2021 07/07/2015 07/07/2015 07/07/2015 Current

AMARILLO, TX 79124

AUSTIN ACCESS CARE130375 51233418108620 BURNET ROAD SUITE 400 03/31/2022 03/15/2018 03/15/2018 03/15/2018 Current

AUSTIN, TX 78757

AUSTIN ENDOSCOPY CENTER130412 51237115798015 SHOAL CREEK SUITE 300 09/30/2022 09/30/2018 12/03/2018 09/30/2018 Current

AUSTIN, TX 78757

AUSTIN ENDOSCOPY CENTER130413 51253280004310 JAMES CASEY STREET SUITE 4B

2ND FLOOR

09/30/2022 09/30/2018 12/03/2018 09/30/2018 Current

AUSTIN, TX 78745

AUSTIN ENDOSCOPY CENTER130453 73720776173944 RANCH ROAD 620 SOUTH BLDG

8 SUITE 103

11/30/2021 11/26/2019 11/26/2019 11/26/2019 Current

BEE CAVE, TX 78738

Page 2 of 396/9/2021

Page 3: Profession Roster Report - Texas Health and Human Services · 2021. 6. 15. · el paso, tx 79925 130176 bay area endoscopy 444 fm 1959 suite b 2814819400 12/31/2021 12/31/2013 02/12/2014

License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

AUSTIN EYE LASER AND

SURGICENTER

007153 512250202011901 JOLLYVILLE ROAD 02/28/2022 02/10/2000 02/10/2000 01/04/2008 Current

AUSTIN, TX 78759

AUSTIN FERTILITY SURGERY CENTER130293 51245101496500 NORTH MOPAC EXPRESSWAY

BLDG 3 #3104

06/30/2022 06/10/2016 06/10/2016 06/27/2016 Current

AUSTIN, TX 78731

AUSTIN MIDTOWN AMBULATORY

SURGERY CENTER

130379 5129920027901 WEST 38TH STREET SUITE 101 01/31/2022 01/04/2018 01/04/2018 04/04/2018 Current

AUSTIN, TX 78705

AXIS SURGERY CENTER LLC130531 71420621541110 E STATE HWY 114 SUITE 150 04/30/2023 04/14/2021 04/14/2021 04/14/2021 Current

SOUTHLAKE, TX 76092

AZURA SURGERY CENTER STAR130373 2104877827301 NORTH FRIO STREET 03/31/2022 03/02/2018 03/02/2018 10/09/2018 Current

SAN ANTONIO, TX 78207

AZURA SURGICAL CENTER HOUSTON130357 83238609008537 C GULF FREEWAY 12/31/2021 12/27/2017 12/27/2017 12/20/2018 Current

HOUSTON, TX 77017

BAILEY SQUARE SURGERY CENTER000265 51245467531111 WEST 34TH STREET 04/30/2022 04/20/1993 04/20/1993 03/27/2008 Current

AUSTIN, TX 78705

BAPTIST BEAUMONT SURGICAL

AFFILIATES

130490 40983570703560 COLLEGE ST 06/30/2022 06/30/2020 06/30/2020 07/13/2020 Current

BEAUMONT, TX 77701

BASSETT SURGERY CENTER008178 91588110106211 EDGEMERE 03/31/2022 03/04/2005 03/04/2005 01/29/2020 Current

EL PASO, TX 79925

BAY AREA ENDOSCOPY130176 2814819400444 FM 1959 SUITE B 12/31/2021 12/31/2013 02/12/2014 02/13/2014 Current

HOUSTON, TX 77034

BAY AREA HOUSTON ENDOSCOPY

CENTER

130134 28155434941015 MEDICAL CENTER BLVD SUITE

1200

12/31/2022 12/01/2012 12/03/2012 12/12/2012 Current

WEBSTER, TX 77598

BAY AREA SURGICARE CENTER000315 2813322433502 MEDICAL CENTER BLVD 04/30/2022 01/01/1986 01/01/1986 03/13/2008 Current

WEBSTER, TX 77598

BAYLOR SCOTT & WHITE

AMBULATORY ENDOCSCOPY CENTER

008136 469 800 60214708 ALLIANCE BLVD SUITE 210 11/30/2021 11/10/2004 11/10/2004 10/23/2019 Current

PLANO, TX 75093

BAYLOR SCOTT & WHITE HEART AND

VASCULAR HOSPITAL - FORT WORTH

130205 21482006001400 8TH AVE 09/30/2022 09/18/2014 09/18/2014 02/07/2018 Current

FORT WORTH, TX 76104

BAYLOR SCOTT & WHITE ORTHOPEDIC

SURGERY CENTER - WACO

130458 2542025810140 HILLCREST MEDICAL BLVD SUITE

3.00

01/31/2022 01/08/2020 01/08/2020 01/08/2020 Current

Page 3 of 396/9/2021

Page 4: Profession Roster Report - Texas Health and Human Services · 2021. 6. 15. · el paso, tx 79925 130176 bay area endoscopy 444 fm 1959 suite b 2814819400 12/31/2021 12/31/2013 02/12/2014

License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

WACO, TX 76712

BAYLOR SCOTT & WHITE SPORTS

SURGERY CENTER AT THE STAR

130387 97266859113800 GAYLORD PARKWAY SUITE 410 05/31/2022 05/11/2018 05/11/2018 05/11/2018 Current

FRISCO, TX 75034

BAYLOR SCOTT & WHITE SURGERY

CENTER WAXAHACHIE

130173 4698438000106 LUCAS 09/30/2021 09/03/2013 01/10/2014 01/13/2014 Current

WAXAHACHIE, TX 75165

BAYLOR SCOTT & WHITE SURGICAL

HOSPITAL AT SHERMAN - OUTPATIENT

130257 90387009993601 NORTH CALAIS STREET SUITE A 05/31/2023 06/01/2015 06/01/2015 09/10/2015 Current

SHERMAN, TX 75090

BAYLOR SCOTT & WHITE SURGICAL

HOSPITAL-FORT WORTH

130191 8176324534914 LIPSCOMB STREET 12/31/2021 12/31/2013 06/11/2014 11/25/2019 Current

FORT WORTH, TX 76104

BAYLOR SCOTT & WHITE SURGICARE007062 97296116853920 WORTH STREET 07/31/2023 07/16/1999 07/16/1999 10/22/2018 Current

DALLAS, TX 75246

BAYLOR SCOTT & WHITE SURGICARE

FORT WORTH

130267 8173345100750 12TH AVENUE 11/30/2021 11/16/2015 11/16/2015 05/09/2019 Current

FORT WORTH, TX 76104

BAYLOR SCOTT & WHITE SURGICARE

AT CENTENNIAL

008203 21461901204401 COIT ROAD SUITE 100 04/30/2023 04/12/2005 04/12/2005 04/27/2007 Current

FRISCO, TX 75035

BAYLOR SCOTT & WHITE SURGICARE

AT PLANO ALLIANCE

130386 46932586934825 ALLIANCE SUITE 300 05/31/2022 05/07/2018 05/07/2018 05/07/2018 Current

PLANO, TX 75093

BAYLOR SCOTT & WHITE SURGICARE

CARROLLTON

007914 97239504404780 JOSEY LANE NORTH 01/31/2023 01/17/2003 01/17/2003 05/09/2019 Current

CARROLLTON, TX 75010

BAYLOR SCOTT & WHITE SURGICARE

DENTON

007012 9403231393350 SOUTH IH 35 EAST 06/30/2023 06/15/1999 06/15/1999 12/14/2018 Current

DENTON, TX 76205

BAYLOR SCOTT & WHITE SURGICARE

GRANBURY

130006 81757988631717 PALUXY ROAD 04/30/2023 04/17/2009 04/17/2009 12/17/2018 Current

GRANBURY, TX 76048

BAYLOR SCOTT & WHITE SURGICARE

NORTH DALLAS

130258 469374640012230 COIT ROAD, SUITE 200 09/30/2021 09/15/2015 09/15/2015 12/17/2018 Current

DALLAS, TX 75251

BAYLOR SCOTT & WHITE SURGICARE

PLANO PARKWAY

130082 46932602024031 WEST PLANO PARKWAY SUITE

100

03/31/2023 03/01/2011 04/01/2011 12/20/2018 Current

PLANO, TX 75093

Page 4 of 396/9/2021

Page 5: Profession Roster Report - Texas Health and Human Services · 2021. 6. 15. · el paso, tx 79925 130176 bay area endoscopy 444 fm 1959 suite b 2814819400 12/31/2021 12/31/2013 02/12/2014

License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

BAYLOR SCOTT & WHITE SURGICARE-

NORTH GARLAND

008192 21470318007150 NORTH GEORGE BUSH HIGHWAY

SUITE 101

04/30/2023 04/04/2005 04/04/2005 01/15/2019 Current

GARLAND, TX 75044

BAYLOR SCOTT & WHITE SURGICARE-

PLANO

008585 21429130001701 OHIO DRIVE 11/30/2021 11/15/2007 11/15/2007 04/16/2019 Current

PLANO, TX 75093-5208

BAYLOR SCOTT & WHITE SURGICARE-

ROCKWALL

008418 9727726166825 WEST YELLOW JACKET LANE 10/31/2022 09/01/2006 09/01/2006 05/09/2019 Current

ROCKWALL, TX 75087

BAYLOR SCOTT & WHITE

SURGICARE-GRAPEVINE

007819 81741043002040 WEST STATE HIGHWAY 114 01/31/2022 01/02/2002 01/02/2002 05/09/2019 Current

GRAPEVINE, TX 76051

BAYLOR SCOTT & WHITE

SURGICARE-MANSFIELD

130056 8174532744280 REGENCY PARKWAY 10/31/2022 10/14/2010 10/14/2010 05/09/2019 Current

MANSFIELD, TX 76063

BAYLOR SCOTT & WHITE

SURGICARE-OAKMONT

008555 81773233007200 OAKMONT BOULEVARD 09/30/2021 09/06/2007 09/06/2007 09/06/2007 Current

FORT WORTH, TX 76132

BAYLOR SCOTT & WHITE TEXAS SPINE

& JOINT HOSPITAL SURGERY CENTER

008239 90352533303414 GOLDEN ROAD 07/31/2021 07/13/2005 07/13/2005 06/08/2007 Current

TYLER, TX 75701

BAYLOR SURGICARE AT GARLAND008512 9724942400530 CLARA BARTON SUITE 100 05/31/2023 05/14/2007 05/14/2007 05/14/2007 Current

GARLAND, TX 75042

BEAR CREEK SURGERY CENTER LLC130214 8175189130100 BOURLAND RD SUITE 110 12/31/2022 12/30/2014 12/30/2014 12/30/2014 Current

KELLER, TX 76248

BEAUMONT HEART & VASCULAR

SURGERY CENTER

130323 4099243996755 NORTH 11TH STREET SUITE

P3970B

01/31/2023 01/20/2017 01/20/2017 01/20/2017 Current

BEAUMONT, TX 77702

BELEZA SURGERY CENTER LLC130380 71379922789899 TOWNE LAKE PARKWAY SUITE

200

04/30/2022 04/06/2018 04/06/2018 04/06/2018 Current

CYPRESS, TX 77433

BELTLINE SURGERY CENTER LLC130032 97220387872858 NORTH BELTLINE ROAD #100 02/28/2022 02/11/2010 02/11/2010 02/11/2010 Current

SUNNYVALE, TX 75182

BINZ SURGERY CENTER LLC130231 71360089191801 BINZ STREET SUITE 200 04/30/2023 04/16/2015 04/16/2015 04/16/2015 Current

HOUSTON, TX 77004

BLUEBONNET SURGERY PAVILION LLC130233 97293740001324 BROWN ST SUITE 600 04/30/2023 04/21/2015 04/21/2015 04/21/2015 Current

WAXAHACHIE, TX 75165

BRAZOSPORT EYE INSTITUTE000157 9792972961103 PARKING WAY 03/31/2022 03/12/1986 03/12/1986 02/07/2008 Current

Page 5 of 396/9/2021

Page 6: Profession Roster Report - Texas Health and Human Services · 2021. 6. 15. · el paso, tx 79925 130176 bay area endoscopy 444 fm 1959 suite b 2814819400 12/31/2021 12/31/2013 02/12/2014

License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

LAKE JACKSON, TX 77566

BRECKENRIDGE SURGERY CENTER008161 97247058593201 EAST GEORGE BUSH FREEWAY

SUITE 100

01/31/2023 01/31/2005 01/31/2005 12/23/2010 Current

RICHARDSON, TX 75082

BROWNSVILLE SURGERY CENTER130455 95670822425700 NORTH EXPRESSWAY SUITE 201 12/31/2021 12/30/2019 12/30/2019 01/02/2020 Current

BROWNSVILLE, TX 78526

CALLOWAY CREEK SURGERY CENTER008592 81754840004300 CITY POINT DRIVE SUITE 100 11/30/2021 11/29/2007 11/29/2007 02/20/2014 Current

NORTH RICHLAND HILLS, TX 76180

CAPLAN SURGERY CENTER007960 71352616003100 WESLAYAN SUITE 400 06/30/2023 06/20/2003 06/20/2003 05/30/2007 Current

HOUSTON, TX 77027

CAPSTONE SURGERY CENTER LLC130479 83283156918700 S GESSNER ROAD SUITE 200 02/28/2022 03/01/2020 03/01/2020 05/08/2020 Current

HOUSTON, TX 77074

CAREOS130510 51245843913705 MEDICAL PARKWAY SUITE 110 10/31/2022 11/01/2020 11/01/2020 11/19/2020 Current

AUSTIN, TX 78705

CASTLE HILLS SURGERY CENTER130130 21021853671646 LOCKHILL SELMA RD 10/31/2022 10/30/2012 10/30/2012 09/24/2014 Current

SAN ANTONIO, TX 78213

CASTLE HILLS SURGICARE LLC130333 97293921414221 MEDICAL PARKWAY BUILDING

100 SUITE 100

05/31/2023 05/30/2017 05/30/2017 05/30/2017 Current

CARROLLTON, TX 75010

CATARACT & SURGICAL CENTER OF

LUBBOCK

007864 80679259005109 80TH STREET 08/31/2021 08/12/2002 08/12/2002 08/23/2007 Current

LUBBOCK, TX 79424

CCA ASC, LLC130294 80635497646200 I - 40 WEST 07/31/2022 07/01/2016 07/01/2016 07/01/2016 Current

AMARILLO, TX 79106

CCRM DALLAS FORT WORTH130394 97237726258380 WARREN PARKWAY #201 05/31/2022 05/30/2018 07/17/2018 05/30/2018 Current

FRISCO, TX 75034

CEDAR PARK SURGERY CENTER LLC130079 5124989006351 CYPRESS CREEK ROAD SUITE 102 02/28/2023 02/21/2011 02/21/2011 07/08/2016 Current

CEDAR PARK, TX 78613

CENTER FOR ASSISTED

REPRODUCTION

007127 81754011571701 PARK PLACE AVENUE 11/30/2022 11/08/1999 11/08/1999 10/20/2008 Current

BEDFORD, TX 76022

CENTER FOR SPECIALTY SURGERY OF

AUSTIN

130248 51258484108015 SHOAL CREEK BOULEVARD

SUITE100

08/31/2021 08/03/2015 08/03/2015 08/03/2015 Current

AUSTIN, TX 78757

CENTRAL PARK SURGERY CENTER008380 8177848300411 CENTRAL PARK DRIVE 07/31/2022 07/14/2006 07/14/2006 07/08/2008 Current

ARLINGTON, TX 76014

Page 6 of 396/9/2021

Page 7: Profession Roster Report - Texas Health and Human Services · 2021. 6. 15. · el paso, tx 79925 130176 bay area endoscopy 444 fm 1959 suite b 2814819400 12/31/2021 12/31/2013 02/12/2014

License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

CENTRAL PARK SURGERY CENTER130116 5123232061900 WEST 38TH STREET SUITE 200 07/31/2022 07/01/2012 07/03/2012 07/01/2012 Current

AUSTIN, TX 78705

CENTRAL POINT SURGERY CENTER130283 214754000011442 NORTH CENTRAL EXPRESSWAY 03/31/2022 03/11/2016 03/11/2016 03/11/2016 Current

DALLAS, TX 75243

CENTRAL TEXAS DAY SURGERY

CENTER

130129 25421304893800 S W S YOUNG DRIVE SUITE 204 10/31/2022 10/24/2012 10/24/2012 10/24/2012 Current

KILLEEN, TX 76542

CENTRAL TEXAS ENDOSCOPY CENTER007156 97977442112206 EAST VILLA MARIA ROAD 02/28/2023 02/17/2000 02/17/2000 02/03/2011 Current

BRYAN, TX 77802

CENTRUM SURGERY CENTER LLC130436 83034611302425 BABCOCK ROAD #106 04/30/2023 04/05/2019 06/11/2019 04/05/2019 Current

SAN ANTONIO, TX 78229

CHI ST LUKES HEALTH BAYLOR

MEDICAL CENTER AMB SURGERY

CENTER

130227 71379823051977 BUTLER BOULEVARD 02/28/2023 02/16/2015 02/16/2015 02/16/2015 Current

HOUSTON, TX 77030

CHILDREN 1ST DENTAL & SURGERY

CENTER

130041 97227912002690 N GALLOWAY AVENUE 05/31/2022 05/13/2010 05/13/2010 05/13/2010 Current

MESQUITE, TX 75150

CHILDREN 1ST DENTAL & SURGERY

CENTER

130188 71394477008545 GULF FREEWAY 04/30/2022 04/24/2014 04/24/2014 04/24/2014 Current

HOUSTON, TX 77017

CHILDREN 1ST GRAND PRAIRIE LLC130103 21441215003055 WEST BARDIN ROAD # 400 02/28/2022 02/17/2012 02/17/2012 01/24/2020 Current

GRAND PRAIRIE, TX 75052

CHILDRENS PAVILION SURGERY

CENTER

007908 21445611002350 STEMMONS FREEWAY SUITE 100 12/31/2021 12/30/2002 12/30/2002 12/11/2019 Current

DALLAS, TX 75207

CHOICE CARE SURGERY CENTER130496 43242322722106 N MIDLAND DR STE 100 09/30/2022 09/03/2020 09/03/2020 09/16/2020 Current

MIDLAND, TX 79707

CHRISTUS GOOD SHEPHERD

AMBULATORY SURGICAL CENTER

130368 9033155300703 EAST MARSHALL AVENUE SUITE

2000

08/31/2021 09/01/2017 02/20/2018 10/04/2019 Current

LONGVIEW, TX 75601

CHRISTUS MOTHER FRANCES

HOSPITAL - TYLER

130247 90360639001720 SOUTH BECKHAM, SUITE 103 06/30/2023 06/26/2015 06/26/2015 12/08/2015 Current

TYLER, TX 75701

CHRISTUS SANTA ROSA PHYSICIANS

AMBULATORY SURGERY CENTER-SAN

MAR

130285 51235381611305 WONDER WORLD DR SUITE 105 03/31/2022 03/31/2016 03/31/2016 03/31/2016 Current

SAN MARCOS, TX 78666

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

CHRISTUS SANTA ROSA PHYSICIANS

ASC - NEW BRAUNFELS

130014 83064386001738 EAST COMMON STREET 07/31/2023 07/02/2009 07/02/2009 07/02/2009 Current

NEW BRAUNFELS, TX 78130

CHRISTUS SPOHN CORPUS CHRISTI

OUTPATIENT SURGERY

007863 36185322003636 SOUTH ALAMEDA SUITE A 07/31/2022 07/30/2002 07/30/2002 02/18/2009 Current

CORPUS CHRISTI, TX 78411

CHRISTUS SPOHN SURGICARE OF

CORPUS CHRISTI

008393 3618823204718 ELIZABETH STREET 08/31/2022 09/01/2006 09/01/2006 07/23/2008 Current

CORPUS CHRISTI, TX 78404

CHRISTUS SURGERY CENTER - STONE

OAK

008396 2104996700502 MADISON OAK DRIVE SUITE 500 09/30/2022 09/19/2006 09/19/2006 08/25/2020 Current

SAN ANTONIO, TX 78258

CHRISTUS SURGERY CENTER OLYMPIA

HILLS

130411 210499679013525 CENTERBROOK SUITE 100 09/30/2022 10/01/2018 11/15/2018 10/01/2018 Current

UNIVERSAL CITY, TX 78148

CHRISTUS SURGERY CENTER- ALAMO

HEIGHTS

130430 2109496000423 TREELINE PARK SUITE 202 04/30/2023 04/12/2019 04/12/2019 04/12/2019 Current

SAN ANTONIO, TX 78209

CIGARROA INTERVENTIONAL

INSTITUTE

130469 95623526097105 N BARTLETT AVENUE SUITE 201 03/31/2022 03/20/2020 03/20/2020 03/20/2020 Current

LAREDO, TX 78041

CITYVIEW SURGERY CENTER008142 81778150076551 HARRIS PARKWAY, SUITE 100 11/30/2021 11/23/2004 11/23/2004 10/25/2007 Current

FORT WORTH, TX 76132

CLEARVIEW SURGERY CENTER INC130086 81732927001980 EAST STATE HWY 114 12/31/2022 12/31/2010 06/08/2011 11/15/2011 Current

SOUTHLAKE, TX 76092

CLEBURNE ENDOSCOPY CENTER130290 81789500951701 WALTER HOLLIDAY DRIVE SUITE

100

05/31/2022 05/20/2016 05/20/2016 05/20/2016 Current

CLEBURNE, TX 76033

COASTAL BEND AMBULATORY

SURGICAL CENTER INC

000147 3618884288900 MORGAN 12/31/2021 01/01/1986 01/01/1986 12/03/2007 Current

CORPUS CHRISTI, TX 78404

COASTAL CARDIOVASCULAR CENTER130525 36188432781025 MORGAN AVENUE 02/28/2023 02/23/2021 02/23/2021 02/23/2021 Current

CORPUS CHRISTI, TX 78404

COLLEGE PARK HEART & VASCULAR

SURGERY CENTER

130309 936321008017183 I-45 SOUTH SUITE 360 11/30/2022 11/17/2016 11/17/2016 11/17/2016 Current

THE WOODLANDS, TX 77385

COMFORT SURGERY CENTER OF SAN

ANTONIO LLC

130419 21026780001919 ROGERS ROAD SUITE 102 01/31/2023 01/16/2019 01/16/2019 01/16/2019 Current

SAN ANTONIO, TX 78251

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

COMPLETE SURGERY HOUSTON

NORTHWEST

130406 71346133991900 NORTH LOOP WEST SUITE 600 10/31/2022 10/05/2018 10/05/2018 10/05/2018 Current

HOUSTON, TX 77018

COMPLETE SURGERY MESQUITE130470 71346133993400 IH 30 03/31/2022 03/20/2020 03/20/2020 03/20/2020 Current

MESQUITE, TX 75150

COOK CHILDRENS PEDIATRIC

SURGERY CENTER

130472 97230002154200 W UNIVERSITY DRIVE SUITE 110 04/30/2022 04/22/2020 04/22/2020 04/22/2020 Current

PROSPER, TX 75078

COOK CHILDRENS SURGERY CENTER

LLC

130385 81760525256316 PRECINCT LINE ROAD SUITE B 04/30/2022 04/27/2018 04/27/2018 04/27/2018 Current

HURST, TX 76054

COPPELL SURGERY CENTER OF

HORIZON MEDICAL CENTER

130527 4694515700731 PLAZA BOULEVARD 09/30/2022 10/01/2020 10/01/2020 03/04/2021 Current

COPPELL, TX 75019

CORM SURGICENTER130033 28133200731015 MEDICAL CENTER BLVD SUITE

2200

02/28/2022 02/17/2010 02/17/2010 02/19/2020 Current

WEBSTER, TX 77598

CORPUS CHRISTI ENDOSCOPY CENTER008573 36198593006421 SARATOGA BLVD BUILDING 105 10/31/2021 10/02/2007 10/02/2007 10/12/2007 Current

CORPUS CHRISTI, TX 78414

COVENANT HIGH PLAINS SURGERY

CENTER - 22ND STREET

130250 80677647723610 22ND STREET 07/31/2021 07/31/2015 07/31/2015 08/18/2015 Current

LUBBOCK, TX 79410

COVENANT HIGH PLAINS SURGERY

CENTER - QUAKER AVENUE

130251 80672588012301 QUAKER AVENUE 07/31/2021 07/31/2015 07/31/2015 08/18/2015 Current

LUBBOCK, TX 79410

CRENSHAW AMBULATORY SURGICAL

CENTER

130316 83223008365150 CRENSHAW ROAD SUITE H100 12/31/2022 12/09/2016 12/09/2016 12/09/2016 Current

PASADENA, TX 77505

CRYSTAL OUTPATIENT SURGERY

CENTER

130279 7134672453950 THREADNEEDLE STREET SUITE

250

02/28/2022 02/09/2016 02/09/2016 03/26/2018 Current

HOUSTON, TX 77079

CRYSTAL OUTPATIENT SURGERY

CENTER LAKE JACKSON INC

000269 9794800105215 OAK DRIVE SOUTH, SUITE J 06/30/2022 06/23/1993 06/23/1993 06/25/2008 Current

LAKE JACKSON, TX 77566

CY FAIR SURGERY CENTER007157 281955719411250 FALLBROOK DRIVE 03/31/2022 03/02/2000 03/02/2000 02/01/2008 Current

HOUSTON, TX 77065

CYPRESSWOOD SURGERY CENTER LP130211 34627519919920 CYPRESSWOOD DRIVE SUITE A 11/30/2022 11/25/2014 11/25/2014 02/05/2020 Current

HOUSTON, TX 77070

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

DALLAS DAY SURGERY OF TEXAS

NORTH LTD

008679 21482186139101 NORTH CENTRAL EXPRESSWAY 08/31/2022 08/06/2008 08/06/2008 07/08/2020 Current

DALLAS, TX 75231

DALLAS ENDOSCOPY CENTER LTD008262 21452082355327 NORTH CENTRAL EXPRESSWAY

SUITE 200

08/31/2021 08/25/2005 08/25/2005 07/16/2007 Current

DALLAS, TX 75205

DALLAS IVF SURGERY CENTER LLC130022 21429700222840 LEGACY DRIVE SUITE 110 10/31/2021 10/27/2009 10/27/2009 01/04/2012 Current

FRISCO, TX 75034

DALLAS NEPHROLOGY ASSOCIATES

VASCULAR CENTER DALLAS

130377 21482642243604 LIVE OAK SUITE 300 03/31/2022 03/26/2018 03/26/2018 03/26/2018 Current

DALLAS, TX 75204

DALLAS NEPHROLOGY ASSOCIATES

VASCULAR CENTER PLANO

130356 21457966004401 TRADITION TRAIL 11/30/2021 11/17/2017 11/17/2017 11/17/2017 Current

PLANO, TX 75093

DALLAS PROCEDURE CENTER LLC130485 21430641161854 LAKEPOINTE DRIVE 06/30/2022 06/02/2020 06/02/2020 06/02/2020 Current

LEWISVILLE, TX 75057

DALLAS SURGI CENTER INC000188 21469688288230 WALNUT HILL LANE SUITE 808 11/30/2021 11/19/1987 11/19/1987 11/07/2007 Current

DALLAS, TX 75231

DAY TIME OUTPATIENT SURGERY

CENTER

007141 81773194006311 SOUTHWEST BLVD SUITE B 12/31/2021 12/21/1999 12/21/1999 12/03/2019 Current

FORT WORTH, TX 76132

DERMATOLOGY SURGERY CENTER130136 90353462001367 DOMINION PLAZA 12/31/2022 12/31/2012 12/31/2012 12/31/2012 Current

TYLER, TX 75703

DFW CHILDRENS SURGERY CENTER

LLC

130303 21461351105744 LBJ FREEWAY SUITE 200 09/30/2022 09/06/2016 09/06/2016 09/06/2016 Current

DALLAS, TX 75240

DIGESTIVE DISEASE CENTER130120 71370434506400 FANNIN, SUITE 1400 07/31/2022 07/26/2012 07/26/2012 07/30/2020 Current

HOUSTON, TX 77030

DIGESTIVE HEALTH CENTER AT

REDBIRD SQUARE

007032 21433129223107 WEST CAMP WISDOM ROAD

SUITE 189

06/30/2023 06/30/1999 06/30/1999 05/12/2020 Current

DALLAS, TX 75237

DIGESTIVE HEALTH CENTER OF ALLEN130501 6156651283981 STATE HWY 121 SUITE 2100 10/31/2022 10/16/2020 10/16/2020 10/16/2020 Current

ALLEN, TX 75013

DIGESTIVE HEALTH CENTER OF

BEDFORD

007784 81731802351600 CENTRAL DRIVE SUITE 300 08/31/2021 08/21/2001 08/21/2001 05/12/2020 Current

BEDFORD, TX 76022

DIGESTIVE HEALTH CENTER OF

DALLAS

130460 21473995449500 NORTH CENTRAL EXPRESSWAY

SUITE 200

01/31/2022 01/14/2020 01/14/2020 01/14/2020 Current

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

DALLAS, TX 75231

DIGESTIVE HEALTH CENTER OF

NORTH RICHLAND HILLS

008398 46971350527640 NORTHEAST LOOP 820 SUITE 96 09/30/2022 09/20/2006 09/20/2006 03/16/2020 Current

NORTH RICHLAND HILLS, TX 76180

DIGESTIVE HEALTH CENTER OF

PLANO

130167 61524037413500 PRESTON ROAD SUITE 200 11/30/2021 11/22/2013 11/22/2013 06/16/2020 Current

PLANO, TX 75093

DOCTORS HOSPITAL AT RENAISSANCE

LTD OUTPATIENT SURGICAL CENTER

130254 95636272945520 LEONARDO DA VINCI 08/31/2021 08/31/2015 08/31/2015 09/11/2019 Current

EDINBURG, TX 78539

DOCTORS SURGERY CENTER INC000295 93656982785300 NORTH STREET 09/30/2022 09/09/1994 09/09/1994 08/06/2008 Current

NACOGDOCHES, TX 75965

DOCTORS UNITED SURGERY CENTER130415 71394703305146 PRESTON AVENUE 12/31/2022 12/21/2018 12/21/2018 10/22/2019 Current

PASADENA, TX 77505

DODSON SURGERY CENTER130108 68288543401500 COOPER ST 03/31/2022 03/14/2012 03/14/2012 03/14/2012 Current

FORT WORTH, TX 76104

DOMAIN SURGICAL LLC130429 80635054372300 WOLFLIN AVENUE 04/30/2023 04/08/2019 04/08/2019 04/08/2019 Current

AMARILLO, TX 79109

DOVE POINTE SURGERY CENTER000390 95668657885520 NORTH C STREET 09/30/2021 09/17/1998 09/17/1998 01/03/2013 Current

MCALLEN, TX 78504

EAST EL PASO SURGERY CENTER007329 91559533537835 CORRAL DRIVE 06/30/2022 06/13/2001 06/13/2001 05/19/2008 Current

EL PASO, TX 79915

EAST TEXAS EYE ASSOCIATES

SURGERY CENTER

000210 93663483811306 WEST FRANK AVENUE 10/31/2021 10/04/1988 10/04/1988 10/04/2019 Current

LUFKIN, TX 75904

EAST TEXAS SURGERY CENTER130522 90355833331402 MEDICAL DRIVE 12/31/2022 12/17/2020 12/17/2020 02/05/2021 Current

SULPHUR SPRINGS, TX 75482

EASTSIDE SURGERY CENTER007237 713451429910918 EAST FREEWAY 10/31/2022 10/25/2000 10/25/2000 08/06/2008 Current

HOUSTON, TX 77029

EL PASO CENTER FOR

GASTROINTESTINAL ENDOSCOPY LLC

008549 91554553001620 NORTH MESA 08/31/2021 08/23/2007 08/23/2007 08/23/2007 Current

EL PASO, TX 79902

EL PASO DAY SURGERY008139 91559493331300 MURCHISON SUITE 200 11/30/2022 11/15/2004 11/15/2004 10/20/2008 Current

EL PASO, TX 79902

ELITE MINIMALLY INVASIVE SURGERY

OF OAKBEND HEALTH SYSTEM

130246 71359559006655 TRAVIS STREET SUITE 200 04/30/2023 05/01/2015 05/01/2015 07/15/2015 Current

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

HOUSTON, TX 77030

ELM PLACE AMBULATORY SURGICAL

CENTER

000166 32569506002217 SOUTH DANVILLE DRIVE 11/30/2021 11/05/1986 11/05/1986 12/06/2019 Current

ABILENE, TX 79605

ENCOR ASC LLC130516 97294558002200 PHYSICIANS BLVD SUITE A 12/31/2022 12/18/2020 12/18/2020 12/21/2020 Current

ENNIS, TX 75119

ENDEAVOR CLINICAL TRIALS LLC130482 21063412538214 WURZBACH RD 05/31/2022 05/21/2020 05/21/2020 05/21/2020 Current

SAN ANTONIO, TX 78229

ENDOSCOPY CENTER AT MED POINT007963 95668726731200 EAST SAVANNAH AVENUE SUITE

15

06/30/2022 06/30/2003 06/30/2003 05/14/2008 Current

MCALLEN, TX 78503

ENDOSCOPY CENTER OF EL PASO000404 91554450001300 MURCHISON DRIVE SUITE 180 12/31/2021 12/10/1998 12/10/1998 11/15/2007 Current

EL PASO, TX 79902

ENDOSCOPY CENTER OF SOUTHEAST

TEXAS

008331 4098335555950 NORTH 14TH STREET SUITE 200 02/28/2022 02/28/2006 02/28/2006 01/10/2012 Current

BEAUMONT, TX 77702

EXECUTIVE SURGERY CENTER130170 832698372013603 MICHEL ROAD 12/31/2021 12/12/2013 12/12/2013 11/05/2019 Current

TOMBALL, TX 77375

EYE 35 ASC LLC130359 210888520017005 IH 35 N SUITE 2 01/31/2022 01/03/2018 01/03/2018 02/20/2018 Current

SCHERTZ, TX 78154

EYE SURGERY CENTER OF EAST

TEXAS PLLC

130351 90359505002448 EAST 5TH STREET 10/31/2021 10/18/2017 10/18/2017 10/18/2017 Current

TYLER, TX 75701

EYE SURGERY CENTER OF NORTH

DALLAS

130201 97238020203100 E TRINITY MILLS ROAD 08/31/2022 08/22/2014 08/22/2014 03/04/2015 Current

CARROLLTON, TX 75006

FACIAL PLASTIC & COSMETIC

SURGICAL CENTER

000111 32569536306300 REGIONAL PLAZA SUITE 475 12/31/2021 01/01/1986 01/01/1986 11/14/2007 Current

ABILENE, TX 79606

FALCONHEAD SURGERY CENTER LLC130518 512913297214425 FALCONHEAD BLVD BLDG F

SUITE 111

12/31/2022 12/29/2020 12/29/2020 12/29/2020 Current

AUSTIN, TX 78738

FANNIN SURGICARE008259 71379638007700 FANNIN STREET 08/31/2021 08/22/2005 08/22/2005 10/14/2019 Current

HOUSTON, TX 77054

FIRST CHOICE AMBULATORY

SURGICAL CENTER LLC

130523 21091282047902 EWING HALSELL 02/28/2023 02/10/2021 02/10/2021 03/04/2021 Current

SAN ANTONIO, TX 78229

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

FIRST COLONY SURGERY CENTER LLC130320 9724972290600 FERRIS AVENUE SUITE B 12/31/2022 12/27/2016 12/27/2016 12/27/2016 Current

WAXAHACHIE, TX 75165

FIRST STREET SURGICAL CENTER130487 7136651111411 FIRST STREET 12/31/2021 12/16/2019 12/16/2019 06/12/2020 Current

BELLAIRE, TX 77401

FISH POND SURGERY CENTER008750 2547519836601 WEST HWY 6 SUITE 109 01/31/2023 01/20/2009 01/20/2009 12/10/2010 Current

WACO, TX 76710

FOREST LANDING SURGICAL CENTER

LLC

130502 93624721409303 NEW TRAILS DRIVE SUITE 185 10/31/2022 10/12/2020 10/12/2020 10/20/2020 Current

THE WOODLANDS, TX 77381

FORT BEND SURGERY CENTER OF

OAKBEND HEALTH SYSTEM

130307 281313730014851 SOUTHWEST FREEWAY 10/31/2022 10/15/2016 10/15/2016 11/07/2016 Current

SUGAR LAND, TX 77478

FORT WORTH ENDOSCOPY CENTER008397 8173326500900 WEST MAGNOLIA AVENUE SUITE

101

09/30/2022 09/19/2006 09/19/2006 07/14/2016 Current

FORT WORTH, TX 76104

FRISCO ASC LLC130463 97271248005616 WARREN PARKWAY SUITE 100 10/31/2021 10/11/2019 10/11/2019 02/05/2020 Current

FRISCO, TX 75034

FRISCO FIRST SURGERY CENTER130422 97294362208740 OHIO DRIVE SUITE B-1 01/31/2023 01/29/2019 01/29/2019 01/29/2019 Current

PLANO, TX 75024

GAB ENDOSCOPY CENTER LTD007994 2102533430621 CAMDEN STREET #102 10/31/2021 10/20/2003 10/20/2003 09/05/2007 Current

SAN ANTONIO, TX 78215

GASTROENTEROLOGY CONSULTANTS

OF SAN ANTONIO - NE

130192 210614123412850 TOEPPERWEIN ROAD 06/30/2022 06/18/2014 06/18/2014 06/18/2014 Current

LIVE OAK, TX 78233

GASTROENTEROLOGY CONSULTANTS

OF SAN ANTONIO - STONE OAK

130139 2106141234855 PROTON ROAD 12/31/2022 12/20/2012 02/01/2013 12/20/2012 Current

SAN ANTONIO, TX 78258

GASTROENTEROLOGY CONSULTANTS

OF SAN ANTONIO- MEDICAL CENTER

130325 21061412345223 HAMILTON WOLFE 03/31/2023 03/16/2017 03/16/2017 03/16/2017 Current

SAN ANTONIO, TX 78229

GASTROINTESTINAL ENDOSCOPY

CENTER

008151 97261297711600 COIT ROAD SUITE 401A 12/31/2021 12/01/2004 12/01/2004 11/23/2011 Current

PLANO, TX 75075

GATEWAY SURGICAL CENTER130473 91526348503215 GATEWAY BLVD WEST STE. 210 04/30/2022 04/23/2020 04/23/2020 04/23/2020 Current

EL PASO, TX 79903

GRACE AMBULATORY SURGERY

CENTER LLC

130521 2144509926470 E STATE HIGHWAY 114 01/31/2023 01/19/2021 01/19/2021 01/19/2021 Current

Page 13 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

SOUTHLAKE, TX 76092

GRACE SURGICAL HOSPITAL130005 80672540004515 MARSHA SHARP FREEWAY 04/30/2023 04/06/2009 04/06/2009 09/07/2011 Current

LUBBOCK, TX 79407

GRAMERCY OUTPATIENT SURGERY

CENTER

000239 71366069002727 GRAMERCY STREET 11/30/2022 04/28/1986 04/28/1986 02/22/2011 Current

HOUSTON, TX 77025

GULF COAST SURGERY CENTER130474 40998470903919 TWIN CITY HWY 04/30/2022 04/30/2020 04/30/2020 04/30/2020 Current

PORT ARTHUR, TX 77642

GULFSTREAM SURGICAL FORT WORTH

LLC

130497 2146956273975 HASKELL STREET 08/31/2022 08/26/2020 08/26/2020 09/24/2020 Current

FORT WORTH, TX 76107

HARLINGEN SURGICAL CENTER LLC130054 95642327731515 ED CAREY DRIVE 08/31/2022 09/29/2010 09/29/2010 09/24/2013 Current

HARLINGEN, TX 78550

HAYS SURGERY CENTER130135 5125040202135 BUNTON CREEK ROAD SUITE #

200

12/31/2022 12/03/2012 12/03/2012 12/01/2020 Current

KYLE, TX 78640

HEA GRAMERCY SURGERY CENTER

PLLC DBA HEA SURGERY CENTER

130011 83255371712855 GRAMERCY STREET SUITE 100 05/31/2023 05/11/2009 05/11/2009 05/11/2009 Current

HOUSTON, TX 77025

HEART & VASCULAR SURGERY

CENTER OF FORT WORTH

130440 81733218186949 BRYANT IRVIN ROAD SUITE 110 07/31/2021 07/03/2019 07/03/2019 08/26/2019 Current

FORT WORTH, TX 76132

HEART OF TEXAS SURGERY CENTER

PLLC

130314 25423511227003 WOODWAY DRIVE SUITE 307 12/31/2022 12/07/2016 12/07/2016 12/07/2016 Current

WOODWAY, TX 76712

HEATON LASER AND SURGERY

CENTER LLC

000377 90352604443415 GOLDEN ROAD 05/31/2022 05/21/1998 05/21/1998 04/08/2008 Current

TYLER, TX 75701

HEIGHTS SURGERY CENTER000355 7138382300427 WEST 20TH STREET SUITE 102 06/30/2022 06/04/1997 06/04/1997 06/30/2020 Current

HOUSTON, TX 77008

HENDRICK SURGERY CENTER SOUTH130505 32579454506399 DIRECTORS PKWY STE 100 10/31/2022 10/27/2020 10/27/2020 01/15/2021 Current

ABILENE, TX 79606

HERITAGE SURGERY CENTER000253 97254807711501 B REDBUD BOULEVARD 09/30/2022 09/28/1992 09/28/1992 09/08/2008 Current

MCKINNEY, TX 75069

HIGHLAND PARK PLASTIC SURGERY

CENTER

000351 21436344446110 SHERRY LANE 08/31/2022 08/09/1996 08/09/1996 08/21/2008 Current

DALLAS, TX 75225

Page 14 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

HILL COUNTRY ENDOSCOPY CENTER008256 5125282000801 EAST WHITESTONE SUITE 100 11/30/2021 11/21/2005 11/21/2005 12/09/2016 Current

CEDAR PARK, TX 78613

HILL COUNTRY MEMORIAL SURGERY

CENTER LLC

007933 8307981821204 GATEWAY NORTH SUITE B 03/31/2022 03/19/2003 03/19/2003 10/16/2020 Current

MARBLE FALLS, TX 78654

HMU SURGICAL CENTER130328 71363444334219 RICHMOND AVENUE SUITE 100 03/31/2023 04/01/2017 04/01/2017 04/26/2017 Current

HOUSTON, TX 77027

HORIZON SURGERY CENTER PLLC130513 28174277502813 SMITH RANCH ROAD SUITE 180 09/30/2022 09/28/2020 09/28/2020 12/11/2020 Current

PEARLAND, TX 77584

HOURGLASS OR SERVICES LLC130506 713636272912721 SAWMILL RD 10/31/2022 10/29/2020 10/29/2020 10/29/2020 Current

THE WOODLANDS, TX 77380

HOUSTON CHILDRENS DENTAL

CENTER

130077 71348195007007 NORTH FREEWAY SUITE 400 02/28/2023 02/08/2011 02/08/2011 02/09/2011 Current

HOUSTON, TX 77076

HOUSTON METHODIST BAYTOWN

AMBULATORY SURGERY CENTER

130142 28183782171677 WEST BAKER STREET 03/31/2023 03/04/2013 03/04/2013 05/06/2019 Current

BAYTOWN, TX 77521

HOUSTON METHODIST SURGERY

CENTER - NASSAU BAY

130177 28133555112020 NASA PARKWAY SUITE 100 02/28/2022 02/01/2014 02/13/2014 02/28/2020 Current

NASSAU BAY, TX 77058

HOUSTON METHODIST

WILLOWBROOK HOSPITAL

OUTPATIENT SURGERY DEPT

008623 281477100113802 CENTERFIELD DRIVE SUITE 100 01/31/2022 01/29/2008 01/29/2008 02/04/2020 Current

HOUSTON, TX 77070

HOUSTON ORTHOPEDIC & SPINE

SURGERY CENTER

130255 2816469832750 WESTGREEN BLVD SUITE 103 09/30/2021 09/03/2015 09/03/2015 01/08/2020 Current

KATY, TX 77450

HOUSTON PREMIER SURGERY CENTER

IN THE VILLAGES

130459 28193065008731 KATY FREEWAY SUITE 350 01/31/2022 01/09/2020 01/09/2020 01/09/2020 Current

HOUSTON, TX 77024

HOUSTON SURGERY CENTER130226 71339515909180 KATY FREEWAY, STE 250 02/28/2023 02/15/2015 02/15/2015 02/15/2015 Current

HOUSTON, TX 77055

HOWERTON SURGICAL CENTER LLC130007 51244407012610 SOUTH IH 35 04/30/2023 04/22/2009 04/22/2009 04/22/2009 Current

AUSTIN, TX 78704

HUEBNER AMBULATORY SURGERY

CENTER

130329 21094309909618 HUEBNER ROAD SUITE 111 04/30/2023 04/27/2017 04/27/2017 04/27/2017 Current

SAN ANTONIO, TX 78240

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

HUMBLE KINGWOOD ENDOSCOPY

CENTER

130096 281312690019502 MCKAY DRIVE SUITE 101 11/30/2021 11/15/2011 11/15/2011 11/15/2011 Current

HUMBLE, TX 77338

HUMBLE VASCULAR SURGICAL

CENTER INC.

130371 71382008068411 FM 1960 BYPASS ROAD WEST

SUITE A

02/28/2022 02/23/2018 02/23/2018 02/23/2018 Current

HUMBLE, TX 77338

HYDE PARK SURGERY CENTER008677 51242023034611 GUADALUPE SUITE 100 08/31/2022 08/06/2008 08/06/2008 08/06/2008 Current

AUSTIN, TX 78751

IMPERIAL SURGERY CENTER130511 713559910013114 FM 1960 SUITE 118 09/30/2022 10/01/2020 10/01/2020 12/04/2020 Current

HOUSTON, TX 77065

INNOVATIONS SURGERY CENTER LP130500 9037292888300 WILLOW CREEK PARKWAY SUITE

100

10/31/2022 10/05/2020 10/05/2020 10/16/2020 Current

PALESTINE, TX 75801

INOV8 SURGICAL130439 833818809310496 KATY FREEWAY SUITE 105 06/30/2021 06/18/2019 06/18/2019 06/18/2019 Current

HOUSTON, TX 77043

INTEGRITY WELLNESS CENTER130253 9724354070920 SOUTH BELTLINE SUITE 250 08/31/2021 08/28/2015 08/28/2015 08/28/2015 Current

COPPELL, TX 75019

J GRAFF SURGERY CENTER INC130215 97240377332633 DALLAS PARKWAY 01/31/2023 01/07/2015 01/07/2015 01/08/2015 Current

PLANO, TX 75093

JPS SURGICAL CENTER- ARLINGTON130089 81770216224400 NEW YORK AVENUE 08/31/2021 08/29/2011 08/29/2011 08/29/2011 Current

ARLINGTON, TX 76018

KATY AREA SURGICAL CENTER130297 713526160021502 MERCHANTS WAY 08/31/2022 08/09/2016 08/09/2016 01/11/2018 Current

KATY, TX 77449

KELSEY-SEYBOLD CLINIC

AMBULATORY SURGICAL CENTER

130442 71344200002727 W HOLCOMBE BLVD. 3RD FLOOR 07/31/2021 08/01/2019 08/01/2019 08/09/2019 Current

HOUSTON, TX 77025

KELSEY-SEYBOLD CLINIC

AMBULATORY SURGICAL CENTER

SPRING

130441 713442000015655 CYPRESS WOODS MEDICAL DR.

SUITE 100

07/31/2021 08/01/2019 08/01/2019 08/09/2019 Current

HOUSTON, TX 77014

KERRVILLE AMBULATORY SURGERY

CENTER LLC

008616 83089624441001 WATER STREET UNIT C 01/31/2022 01/11/2008 01/11/2008 01/11/2008 Current

KERRVILLE, TX 78028

KEYSTONE SURGICENTER LLC130301 93632143453115 COLLEGE PARK DRIVE SUITE

101B

08/31/2022 09/01/2016 09/01/2016 09/03/2020 Current

THE WOODLANDS, TX 77384

KINGWOOD ENDOSCOPY130468 8323444008310 KINGWOOD EXECUTIVE DRIVE

SUITE A

03/31/2022 03/16/2020 03/16/2020 03/16/2020 Current

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

KINGWOOD, TX 77339

LAKE GRANBURY MEDICAL CENTER008038 81740830431308 PALUXY ROAD 03/31/2023 03/08/2004 03/08/2004 02/17/2009 Current

GRANBURY, TX 76048

LAKE JACKSON ENDOSCOPY CENTER,

LP

130259 9795292270219 OAK DRIVE SOUTH 09/30/2021 09/21/2015 09/21/2015 10/13/2015 Current

LAKE JACKSON, TX 77566

LAKE POINTE SURGERY CENTER130149 713737560516614 CREEK BEND DRIVE 05/31/2023 05/30/2013 05/30/2013 05/30/2013 Current

SUGAR LAND, TX 77478

LAKESHORE SURGICAL CENTER LLC130480 28141495966701 LAKE WOODLANDS DR SUITE

175

03/31/2022 04/01/2020 04/01/2020 05/13/2020 Current

SPRING, TX 77382

LAREDO DIGESTIVE HEALTH CENTER

LLC

130008 95672800306999 MCPHERSON AVENUE SUITE 219 04/30/2023 04/24/2009 04/24/2009 04/24/2009 Current

LAREDO, TX 78041

LAREDO LASER & SURGERY LTD008685 95656854415313 MCPHERSON ROAD 08/31/2022 08/20/2008 08/20/2008 08/20/2008 Current

LAREDO, TX 78041

LAREDO SURGERY CENTER LLC130509 281777087810410 MEDICAL LOOP UNIT 4A 11/30/2022 11/16/2020 11/16/2020 11/16/2020 Current

LAREDO, TX 78045

LEGENT CHILDRENS OUTPATIENT

SURGERY DALLAS

130392 97280876747150 GREENVILLE AVENUE SUITE 400 06/30/2022 06/21/2018 06/21/2018 01/09/2019 Current

DALLAS, TX 75231

LEGENT OUTPATIENT SURGERY

AUSTIN

130186 51286107003107 OAK CREEK DRIVE STE 100 12/31/2021 12/20/2013 03/27/2014 01/09/2019 Current

AUSTIN, TX 78727

LEGENT OUTPATIENT SURGERY

EULESS

130156 8175533627461 WESTPARK WAY 08/31/2021 08/26/2013 08/26/2013 07/16/2020 Current

EULESS, TX 76040

LEGENT OUTPATIENT SURGERY

FRISCO

130343 46921383108350 DALLAS PARKWAY SUITE 100 08/31/2021 08/02/2017 08/02/2017 01/09/2019 Current

FRISCO, TX 75034

LEGENT WESTOVER HILLS130365 21026715891927 ROGERS ROAD 02/28/2022 02/05/2018 02/12/2018 07/16/2020 Current

SAN ANTONIO, TX 78251

LEWISVILLE SURGERY CENTER000387 9724200023591 WEST MAIN STREET 07/31/2022 07/08/1998 07/08/1998 08/11/2020 Current

LEWISVILLE, TX 75057

LIVE OAK SURGERY CENTER130372 46948810007211 PRESTON ROAD SUITE 2100 03/31/2022 03/01/2018 03/01/2018 05/10/2018 Current

PLANO, TX 75024

LMC NORTH008003 95679625957210 MCPHERSON ROAD 11/30/2022 11/06/2003 11/06/2003 10/06/2008 Current

Page 17 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

LAREDO, TX 78041

LONE STAR ENDOSCOPY FLOWER

MOUND

130200 81733736711001 SURREY LANE 08/31/2022 08/22/2014 08/22/2014 07/17/2020 Current

FLOWER MOUND, TX 75022

LONE STAR ENDOSCOPY SOUTHLAKE130353 8179121999515 SOUTH NOLEN DRIVE 10/31/2021 10/19/2017 10/19/2017 10/19/2017 Current

SOUTHLAKE, TX 76092

LONESTAR AMBULATORY SURGICAL

CENTER

130049 81741020302201 WESTGATE PLAZA 07/31/2022 07/14/2010 07/14/2010 07/14/2010 Current

GRAPEVINE, TX 76051

LONESTAR ENDOSCOPY CENTER LLC130072 8173373671180 BEAR CREEK PARKWAY 12/31/2022 12/23/2010 12/23/2010 12/30/2010 Current

KELLER, TX 76248-2500

LUBBOCK SURGERY CENTER130347 80641265833416 22ND STREET 09/30/2021 09/29/2017 09/29/2017 09/29/2017 Current

LUBBOCK, TX 79410

LUBBOCK VASCULAR ACCESS CENTER130322 80679222221126 SLIDE ROAD SUITE #1 01/31/2023 01/12/2017 01/12/2017 01/12/2017 Current

LUBBOCK, TX 79416

LUFKIN ENDOSCOPY CENTER000212 9366343713317 GASLIGHT BOULEVARD 01/31/2023 01/16/1989 01/16/1989 01/31/2011 Current

LUFKIN, TX 75904

MANN CATARACT SURGERY CENTER008536 71327524375115 MAIN STREET SUITE 100 07/31/2023 07/23/2007 07/23/2007 06/07/2021 Current

HOUSTON, TX 77002

MANN CATARACT SURGERY CENTER007149 281446790018850 SOUTH MEMORIAL BLVD SUITE

300

04/30/2022 04/27/1999 04/27/1999 03/09/2020 Current

HUMBLE, TX 77338

MANSFIELD ENDOSCOPY CENTER LLC130529 2146977314647 N MILLER ROAD 03/31/2023 03/30/2021 03/30/2021 03/30/2021 Current

MANSFIELD, TX 76063

MAPLESHADE SURGERY CENTER130475 9725991447960 OHIO DRIVE SUITE 100 04/30/2022 04/30/2020 04/30/2020 04/30/2020 Current

PLANO, TX 75093

MAPLEWOOD AMBULATORY SURGERY

CENTER INC

000388 94069685004301 MAPLEWOOD AVENUE SUITE C 01/31/2023 01/20/1998 01/20/1998 01/27/2011 Current

WICHITA FALLS, TX 76308

MCALLEN SURGICAL SPECIALTY

CENTER LTD

007782 95663172021309 EAST RIDGE ROAD SUITE 3 08/31/2021 08/16/2001 08/16/2001 08/20/2007 Current

MCALLEN, TX 78503

MCKINNEY OUTPATIENT SURGICAL

CENTER

130427 46968790151505 HARROUN AVENUE SUITE 1 03/31/2023 03/20/2019 03/20/2019 03/20/2019 Current

MCKINNEY, TX 75069

MD AESTHETIC SURGERY CENTER007855 71352891001200 BINZ SUITE 1000 06/30/2022 06/11/2002 06/11/2002 05/19/2008 Current

Page 18 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

HOUSTON, TX 77004

MEDFINITY HEALTH SURGERY

CENTER - HEB

130308 68230511121305 AIRPORT FREEWAY SUITE 123 11/30/2022 11/08/2016 11/08/2016 11/08/2016 Current

BEDFORD, TX 76021

MEDFINITY HEALTH SURGERY

CENTER - PLANO

130319 46960982805085 WEST PARK BLVD SUITE 180B 12/31/2022 12/22/2016 12/22/2016 12/22/2016 Current

PLANO, TX 75093

MEDICAL ARTS SURGERY CENTER008491 93656436003302 NORTH EAST STALLINGS DRIVE 04/30/2023 04/02/2007 04/02/2007 04/02/2007 Current

NACOGDOCHES, TX 75965

MEDICAL CENTER ENDOSCOPY LLC000399 71379605006560 FANNIN SUITE 600 10/31/2022 10/28/1998 10/28/1998 12/17/2019 Current

HOUSTON, TX 77030

MEDICAL CITY AMBULATORY

SURGERY CENTER DALLAS

008279 97256661717777 FOREST LANE SUITE C150 09/30/2021 09/27/2005 09/27/2005 12/12/2018 Current

DALLAS, TX 75230

MEDICAL CITY SURGERY CENTER

DENTON

008176 94034955003316 COLORADO BLVD 03/31/2023 03/02/2005 03/02/2005 12/12/2018 Current

DENTON, TX 76210

MEDICAL CITY SURGERY CENTER

FORT WORTH

000270 8173366060909 NINTH AVENUE 07/31/2021 07/16/1993 07/16/1993 12/12/2018 Current

FORT WORTH, TX 76104

MEDICAL CITY SURGERY CENTER LAS

COLINAS

000299 97225701444255 NORTH MACARTHUR

BOULEVARD

11/30/2022 11/30/1994 11/30/1994 10/02/2008 Current

IRVING, TX 75038

MEDICAL CITY SURGERY CENTER

MCKINNEY

008024 97254715804510 MEDICAL CENTER DRIVE SUITE

150

02/28/2023 02/10/2004 02/10/2004 12/12/2018 Current

MCKINNEY, TX 75069

MEDICAL CITY SURGERY CENTER

PARK CENTRAL

000217 972661050512200 PARK CENTRAL DRIVE SUITE

300

03/31/2022 04/01/1989 04/01/1989 12/12/2018 Current

DALLAS, TX 75251

MEDICAL CITY WEATHERFORD130354 8175988100905 EAST EUREKA STREET 09/30/2021 10/01/2017 10/01/2017 10/01/2017 Current

WEATHERFORD, TX 76086

MEDICAL COMPLEX SURGERY

CENTER

130349 281290828213500 MEDICAL COMPLEX DRIVE 06/30/2021 07/01/2017 10/06/2017 10/15/2019 Current

TOMBALL, TX 77375

MEDICAL PARK TOWER SURGERY

CENTER

130050 51235430001301 WEST 38TH ST SUITE 109 07/31/2022 07/27/2010 07/27/2010 07/27/2010 Current

AUSTIN, TX 78705

MEMORIAL AMBULATORY SURGERY

CENTER

130447 71392933238731 KATY FREEWAY SUITE 400 10/31/2021 10/09/2019 10/09/2019 10/09/2019 Current

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

HOUSTON, TX 77024

MEMORIAL ENDOSCOPY CENTER130115 71346892001233 CAMPBELL ROAD 07/31/2022 07/01/2012 07/02/2012 07/01/2012 Current

HOUSTON, TX 77055

MEMORIAL HERMANN ENDOSCOPY

CENTER NORTH LOOP

130220 71345727501900 NORTH LOOP WEST SUITE 550 01/31/2023 01/22/2015 01/22/2015 02/23/2015 Current

HOUSTON, TX 77018

MEMORIAL HERMANN MEMORIAL

VILLAGE SURGERY CENTER

130143 71333711111120 BUSINESS CENTER DRIVE SUITE

110

03/31/2023 03/07/2013 03/07/2013 03/17/2017 Current

HOUSTON, TX 77043

MEMORIAL HERMANN SURGERY

CENTER BRAZORIA, LLC

130403 97984859002760 BRAZOS PARKWAY 09/30/2022 09/07/2018 09/19/2018 09/07/2018 Current

ANGLETON, TX 77515

MEMORIAL HERMANN SURGERY

CENTER CONROE

007984 93676034431501 RIVER POINTE DRIVE SUITE 200 09/30/2021 09/15/2003 09/15/2003 08/22/2019 Current

CONROE, TX 77304

MEMORIAL HERMANN SURGERY

CENTER GREATER HEIGHTS

008110 71334310801631 NORTH LOOP WEST SUITE 300 09/30/2021 09/07/2004 09/07/2004 11/23/2015 Current

HOUSTON, TX 77008

MEMORIAL HERMANN SURGERY

CENTER KATY LLP

008424 281644320023920 KATY FREEWAY SUITE 200 11/30/2022 11/14/2006 11/14/2006 11/18/2008 Current

KATY, TX 77494

MEMORIAL HERMANN SURGERY

CENTER KINGSLAND

130003 281492123421720 KINGSLAND BLVD SUITE 101 03/31/2023 03/11/2009 03/11/2009 03/11/2009 Current

KATY, TX 77450

MEMORIAL HERMANN SURGERY

CENTER KIRBY GLEN

130249 71352986002459 S BRAESWOOD BLVD 06/30/2021 07/01/2015 07/01/2015 08/06/2015 Current

HOUSTON, TX 77030

MEMORIAL HERMANN SURGERY

CENTER MAIN STREET

130450 71379999907515 MAIN STREET SUITE 800 06/30/2023 07/01/2019 07/01/2019 11/07/2019 Current

HOUSTON, TX 77030

MEMORIAL HERMANN SURGERY

CENTER PINECROFT

130315 83282351569305 PINECROFT DRIVE SUITE 200 12/31/2022 12/08/2016 12/08/2016 12/08/2016 Current

THE WOODLANDS, TX 77380

MEMORIAL HERMANN SURGERY

CENTER RICHMOND

130454 281344544421155 SOUTHWEST FREEWAY 10/31/2021 10/24/2019 10/24/2019 10/24/2019 Current

RICHMOND, TX 77469

MEMORIAL HERMANN SURGERY

CENTER SOUTHWEST LLP

008394 71334331007789 SOUTHWEST FREEWAY SUITE

200

09/30/2022 09/12/2006 09/12/2006 09/29/2014 Current

HOUSTON, TX 77074

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

MEMORIAL HERMANN SURGERY

CENTER SUGAR LAND

008395 281238160017510 WEST GRAND PARKWAY SUITE

200

09/30/2022 09/13/2006 09/13/2006 08/21/2008 Current

SUGAR LAND, TX 77479

MEMORIAL HERMANN SURGERY

CENTER TEXAS MEDICAL CENTER LLP

008439 71379077106400 FANNIN STREET SUITE 1500 01/31/2023 01/04/2007 01/04/2007 03/10/2021 Current

HOUSTON, TX 77030

MEMORIAL HERMANN SURGERY

CENTER THE WOODLANDS LLP

008254 28129795009200 PINECROFT SUITE 200 08/31/2021 08/08/2005 08/08/2005 09/03/2015 Current

THE WOODLANDS, TX 77380

MEMORIAL HERMANN SURGERY

CENTER WOODLANDS PARKWAY LLC

130085 28136300581441 WOODSTEAD COURT SUITE 100 12/31/2022 12/30/2010 12/30/2010 11/02/2011 Current

THE WOODLANDS, TX 77380-1410

MEMORIAL HOUSTON SURGERY

CENTER

130313 34535218239230 KATY FREEWAY SUITE 601 12/31/2022 12/07/2016 12/07/2016 12/07/2016 Current

HOUSTON, TX 77055

MEMORIAL SURGICAL SOLUTIONS130057 713722740010504 KATY FREEWAY 10/31/2022 10/20/2010 10/20/2010 10/20/2010 Current

HOUSTON, TX 77043

MERCY AMBULATORY SURGERY

CENTER OF DALLAS PLLC

130355 972982769812606 GREENVILLE AVENUE SUITE

190

06/30/2023 06/30/2017 06/30/2017 11/09/2017 Current

DALLAS, TX 75243

MERIDIAN SURGERY CENTER130153 51261775054220 BULL CREEK 07/31/2021 07/11/2013 07/15/2013 08/02/2018 Current

AUSTIN, TX 78731

METHODIST ALLEN SURGERY CENTER130335 97256945001125 RAINTREE CIRCLE SUITE 200 06/30/2021 06/09/2017 06/09/2017 06/09/2017 Current

ALLEN, TX 75013

METHODIST AMBULATORY SURGERY

CENTER - NORTH CENTRAL

007843 210575520019010 STONE OAK PARKWAY 04/30/2022 04/18/2002 04/18/2002 03/27/2008 Current

SAN ANTONIO, TX 78258

METHODIST AMBULATORY SURGERY

CENTER MEDICAL CENTER

008133 21057545844411 MEDICAL DRIVE SUITE 200 11/30/2022 11/01/2004 11/01/2004 10/10/2008 Current

SAN ANTONIO, TX 78229

METHODIST CRAIG RANCH SURGERY

CENTER

130352 46990716506045 ALMA ROAD SUITE 100 10/31/2021 10/19/2017 10/19/2017 10/19/2017 Current

MCKINNEY, TX 75070

METHODIST MANSFIELD

AMBULATORY SURGERY CENTER LLC

130491 6822426006252 MATLOCK ROAD SUITE 430 07/31/2022 07/24/2020 07/24/2020 10/23/2020 Current

MANSFIELD, TX 76063

METHODIST STONE OAK FERTILITY

SURGERY CENTER

130166 210638270718707 HARDY OAK BLVD, SUITE 515 11/30/2021 11/01/2013 11/01/2013 12/30/2019 Current

SAN ANTONIO, TX 78258

Page 21 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

METHODIST SURGERY CENTER

BOERNE

130481 8303316006110 MENGER SPRINGS 05/31/2022 05/19/2020 05/19/2020 05/19/2020 Current

BOERNE, TX 78006

METHODIST SURGERY CENTER

LANDMARK

130534 21058375005510 PRESIDIO PARKWAY SUITE 100 06/30/2023 06/03/2021 06/03/2021 06/03/2021 Current

SAN ANTONIO, TX 78249

METRO ORTHO AND SPINE SURGERY

CENTER OF OAKBEND HEALTH

SYSTEM

130243 71348700014219 RICHMOND AVENUE SUITE 200 04/30/2023 05/01/2015 05/01/2015 07/03/2015 Current

HOUSTON, TX 77027

MID-TOWN SURGICAL CENTER130278 71357102152105 JACKSON STREET SUITE 200 01/31/2022 01/25/2016 01/25/2016 02/01/2016 Current

HOUSTON, TX 77003

MONTFORT SURGICAL CENTER PLLC130391 97233107195520 LBJ FREEWAY SUITE 150 06/30/2022 06/05/2018 06/05/2018 06/05/2018 Current

DALLAS, TX 75240

MOTHER FRANCES HOSPITAL

OUTPATIENT SURGERY CENTER

130178 9035950141415 SOUTH FLEISHEL 02/28/2022 02/19/2014 02/19/2014 03/18/2020 Current

TYLER, TX 75702

MOUNTAIN WEST SURGERY CENTER

OF MESA HILLS SPECIALTY HOSPITAL

130363 91553222223909 NORTH MESA STREET 10/31/2021 10/31/2017 10/31/2017 10/31/2017 Current

EL PASO, TX 79902

MT PLEASANT SURGICAL CENTER000359 90357266552009 NORTH JEFFERSON AVENUE 08/31/2022 08/26/1997 08/26/1997 06/22/2020 Current

MT PLEASANT, TX 75455

MUVE-LAKEWAY AMBULATORY

SURGICAL CENTER LLC

130324 51235782205329 SERENE HILLS DRIVE SUITE 100 03/31/2023 03/15/2017 03/15/2017 03/15/2017 Current

LAKEWAY, TX 78738

MVP SPECIALIST SURGERY CENTER

LLC

130345 71324457217501 FANNIN STREET SUITE 200 09/30/2021 09/15/2017 09/15/2017 09/15/2017 Current

HOUSTON, TX 77054

NACOGDOCHES SURGERY CENTER007238 93656095993610 NORTH UNIVERSITY DRIVE 11/30/2021 11/02/2000 11/02/2000 10/04/2007 Current

NACOGDOCHES, TX 75965

NEW BRAUNFELS SPINE & PAIN

SURGERY CENTER, LLC

130300 8303872343717 GENERATIONS DRIVE SUITE A 08/31/2022 08/12/2016 08/12/2016 08/12/2016 Current

NEW BRAUNFELS, TX 78130

NOLEN SOUTHLAKE SURGICAL

INSTITUTE

130532 6824773579300 SOUTH NOLEN DRIVE #160 02/28/2023 02/04/2021 02/04/2021 04/19/2021 Current

SOUTHLAKE, TX 76092

NORTH AUSTIN SURGERY CENTER008141 512832908812201 RENFERT WAY SUITE 120 11/30/2022 11/23/2004 11/23/2004 12/07/2010 Current

AUSTIN, TX 78758

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

NORTH CENTRAL AMBULATORY

SURGERY CENTER

130414 9301 NORTH CENTRAL EXPRESSWAY

SUITE 670

12/31/2022 12/12/2018 12/12/2018 12/12/2018 Current

DALLAS, TX 75231

NORTH CYPRESS MEDICAL CENTER A

CAMPUS OF KINGWOOD MEDICAL

CENTER

130410 832912635921212 NORTHWEST FREEWAY 08/31/2022 08/31/2018 11/12/2018 11/12/2018 Current

CYPRESS, TX 77339

NORTH DALLAS SURGICARE000279 9729189400375 MUNICIPAL DRIVE SUITE 200 02/28/2022 09/25/1992 09/25/1992 02/25/2020 Current

RICHARDSON, TX 75080

NORTH HOUSTON CARDIOVASCULAR

SURGERY CENTER

130327 713335337419502 MCKAY BOULEVARD SUITE 203 04/30/2023 04/17/2017 04/17/2017 03/30/2021 Current

HUMBLE, TX 77338

NORTH HOUSTON ENDOSCOPY &

SURGERY

008709 2814405797275 LANTERN BEND SUITE 400 10/31/2022 10/24/2008 10/24/2008 10/24/2008 Current

HOUSTON, TX 77090

NORTH PARK HEART & VASCULAR

SURGERY CENTER LLC

130376 469232939311970 NORTH CENTRAL EXPRESSWAY

SUITE 610

03/31/2022 03/22/2018 03/22/2018 03/22/2018 Current

DALLAS, TX 75243

NORTH PARK SURGICAL INSTITUTE130445 972884440010400 NORTH CENTRAL EXPRESSWAY 04/30/2023 04/26/2019 04/26/2019 09/16/2019 Current

DALLAS, TX 75231

NORTH PINES SURGERY CENTER, LLC130272 93664181814019 I 45 NORTH SUITE 150 12/31/2021 12/09/2015 12/09/2015 12/09/2015 Current

CONROE, TX 77304

NORTH TEXAS GI CENTER007788 81726548441001 WALDROP SUITE 705 09/30/2021 09/20/2001 09/20/2001 10/07/2019 Current

ARLINGTON, TX 76012

NORTH TEXAS SURGERY CENTER000354 97228324007992 WEST VIRGINIA DRIVE 03/31/2023 03/04/1997 03/04/1997 02/16/2011 Current

DALLAS, TX 75237

NORTH TEXAS SURGERY CENTER LLC130342 90396530231001 SARA SWAMY DRIVE SUITE 200 09/30/2021 09/11/2017 09/11/2017 09/11/2017 Current

SHERMAN, TX 75090

NORTH TEXAS TEAM CARE SURGERY

CENTER, LLC

130071 97252860903865 CHILDRESS AVENUE SUITE B 12/31/2022 12/23/2010 12/23/2010 02/03/2011 Current

MESQUITE, TX 75150

NORTHSTAR SURGICAL CENTER A

DEPARTMENT OF LUBBOCK HEART

HOSPITAL

130235 80676148804640 NORTH LOOP 289 04/30/2023 04/09/2015 04/09/2015 05/06/2019 Current

LUBBOCK, TX 79416

NORTHWEST SURGERY CENTER LLP008513 512349400011111 RESEARCH BOULEVARD SUITE

LL3

05/31/2023 05/24/2007 05/24/2007 05/24/2007 Current

AUSTIN, TX 78759

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

NORTHWEST SURGERY CENTER RED

OAK

000401 281895910017322 RED OAK DRIVE 11/30/2022 11/12/1998 11/12/1998 03/15/2011 Current

HOUSTON, TX 77090

NUVISION SAME DAY PROCEDURE

CENTER LLC

130437 21045515959725 DATAPOINT DR. STE. 136 06/30/2023 06/14/2019 06/14/2019 06/14/2019 Current

SAN ANTONIO, TX 78229

NW SURGERY CENTER130508 71346231944800 FEDERAL PLAZA DRIVE 11/30/2022 11/05/2020 11/05/2020 11/05/2020 Current

HOUSTON, TX 77092

OAK POINT SURGICAL SUITES LLC130418 46940910912201 K AVENUE SUITE B-100 01/31/2023 01/10/2019 01/10/2019 01/10/2019 Current

PLANO, TX 75074

OAKBEND SURGERY CENTER OF

GRAND PARKWAY

130519 28145641887830 W GRAND PARKWAY SOUTH

SUITE 150

05/31/2022 05/14/2020 05/14/2020 12/29/2020 Current

RICHMOND, TX 77406

OAKS SURGICAL CENTER LLC130495 83257112374126 SOUTHWEST FREEWAY SUITE

275

08/31/2022 08/10/2020 08/10/2020 09/01/2020 Current

HOUSTON, TX 77027

OAKWOOD SURGERY CENTER130112 512246877716030 PARK VALLEY DRIVE SUITE 100 05/31/2022 05/31/2012 05/31/2012 06/01/2012 Current

ROUND ROCK, TX 78681

ODESSA ENDOSCOPY CENTER LLC130059 4323358300315 EAST 5TH STREET 11/30/2022 11/05/2010 11/05/2010 11/05/2010 Current

ODESSA, TX 79761

OPHTHALMOLOGY SURGERY CENTER

OF DALLAS LLC

130034 214750928810740 NORTH CENTRAL EXPRESSWAY

SUITE 400

03/31/2022 03/23/2010 03/23/2010 03/23/2010 Current

DALLAS, TX 75231

ORBIS SURGERY CENTER130528 28156032001050 GEMINI STREET SUITE 101 03/31/2023 03/22/2021 03/22/2021 03/22/2021 Current

HOUSTON, TX 77058

ORTHOPAEDIC ASSOCIATES OF

CENTRAL TEXAS SURGERY CENTER

LLC

130520 51224407667600 N CAPITAL OF TEXAS HWY BLDG

A SUITE 100

01/31/2023 01/07/2021 01/07/2021 01/07/2021 Current

AUSTIN, TX 78731

ORTHOPAEDIC SURGERY CENTER OF

SAN ANTONIO

007839 2102532660400 CONCORD PLAZA DRIVE SUITE

200

04/30/2022 04/05/2002 04/05/2002 03/13/2008 Current

SAN ANTONIO, TX 78216

OSD SURGERY CENTER LP130524 28140432806921 BRISBANE COURT SUITE 100 02/28/2023 02/22/2021 02/22/2021 02/22/2021 Current

SUGAR LAND, TX 77479

OUTPATIENT SURGISITE000173 9039388581401A EAST PINECREST DRIVE 03/31/2022 03/21/1987 03/21/1987 03/10/2008 Current

MARSHALL, TX 75670

PAIN CARE OF NORTH TEXAS LLC008093 21450995301111 RAINTREE CIRCLE SUITE 190 07/31/2022 07/20/2004 07/20/2004 06/03/2008 Current

Page 24 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

ALLEN, TX 75013

PALESTINE LASER & SURGERY

CENTER

007940 9037314653501 B EAST KOLSTAD 04/30/2023 04/21/2003 04/21/2003 04/06/2007 Current

PALESTINE, TX 75801

PARAGON LASER & EYE SURGERY

CENTER LLC

130282 8174628240902 W RANDOL MILL ROAD SUITE 230 03/31/2022 03/03/2016 03/03/2016 03/03/2016 Current

ARLINGTON, TX 76012

PARAMOUNT SURGICAL CENTER PLLC130530 51267766053728 DACOMA STREET SUITE 115 12/31/2022 12/15/2020 12/15/2020 04/01/2021 Current

HOUSTON, TX 77092

PARC SURGICAL CENTER130464 21469562733716 STANDRIDGE DRIVE SUITE 100 02/28/2022 02/04/2020 02/04/2020 02/04/2020 Current

THE COLONY, TX 75056

PARIS CARDIOLOGY CENTER CATH

LAB

130239 90378314442620 SPUR 139 05/31/2023 05/26/2015 05/26/2015 05/26/2015 Current

PARIS, TX 75462

PARIS SURGERY CENTER, LLC130187 90327299242905 PINE MILL ROAD 04/30/2022 04/09/2014 04/09/2014 04/09/2014 Current

PARIS, TX 75460

PARK AMBULATORY SURGERY

CENTER, LLC

130172 21429970105055 W. PARK BLVD. SUITE 800 01/31/2022 01/09/2014 01/09/2014 01/09/2014 Current

PLANO, TX 75093

PARK CITIES SURGERY CENTER007967 21470669016901 SNIDER PLAZA SUITE 300 07/31/2022 07/22/2003 07/22/2003 06/06/2012 Current

UNIVERSITY PARK, TX 75205

PARK HUDSON SURGERY CENTER008244 97977490533811 SAGEBRIAR DRIVE 07/31/2023 07/20/2005 07/20/2005 06/08/2007 Current

BRYAN, TX 77802

PARKHILL SURGERY CENTER PLANO

LLC

130512 46930031317000 W PLANO PARKWAY SUITE 100 11/30/2022 11/05/2020 11/05/2020 12/09/2020 Current

PLANO, TX 75093

PARKSIDE SURGERY CENTER130260 9367607660690 S LOOP 336 W SUITE 130 09/30/2021 09/29/2015 09/29/2015 09/29/2015 Current

CONROE, TX 77304

PASO DEL NORTE SURGERY CENTER006838 9155328200125 WEST CASTELLANO 02/28/2023 02/08/1999 02/08/1999 02/18/2011 Current

EL PASO, TX 79912

PASTEUR PLAZA SURGERY CENTER LP007850 21058159007909 FREDERICKSBURG ROAD SUITE

222

05/31/2023 05/21/2002 05/21/2002 04/11/2013 Current

SAN ANTONIO, TX 78229

PEAK HEALTH SURGICARE LLC130467 2144179065610 N COIT SUITE 2100 02/28/2022 02/06/2020 02/06/2020 02/06/2020 Current

RICHARDSON, TX 75080

PEAK HEALTH SURGICARE OF

HORIZON MEDICAL CENTER

130466 21482120011190 N HASKELL 12/31/2021 12/19/2019 12/19/2019 02/05/2020 Current

Page 25 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

DALLAS, TX 75204

PEARLAND SURGERY CENTER, LLC130117 832255750015015 KIRBY DRIVE SUITE 100 07/31/2022 07/12/2012 07/12/2012 07/12/2012 Current

PEARLAND, TX 77047

PETERSON REGIONAL AMBULATORY

CARE CENTER

007181 8302587728260 CULLY DRIVE 05/31/2022 05/23/2000 05/23/2000 04/09/2008 Current

KERRVILLE, TX 78028

PHYSICIAN SURGERY CENTER OF

LONGVIEW REGIONAL MEDICAL

CENTER

008594 90324892401404 NORTH 4TH STREET 12/31/2021 12/01/2007 12/01/2007 12/17/2019 Current

LONGVIEW, TX 75605

PHYSICIANS DAYSURGERY CENTER007821 21482707603930 CRUTCHER STREET 01/31/2022 01/11/2002 01/11/2002 01/16/2008 Current

DALLAS, TX 75246

PHYSICIANS ENDOSCOPY CENTER130024 71358709093030 SOUTH GESSENER ROAD SUITE

150

11/30/2021 11/05/2009 11/05/2009 11/05/2009 Current

HOUSTON, TX 77063

PHYSICIANS WEST HOUSTON

SURGICAL CT LLC DBA PARK TEN

SURGICAL CT

130266 281647230015775 PARK TEN PLACE 10/31/2021 11/01/2015 11/01/2015 05/24/2016 Current

HOUSTON, TX 77084

PINEY POINT SURGERY CENTER130046 71378282792500 FONDREN SUITE 350 05/31/2022 06/14/2010 06/14/2010 05/27/2010 Current

HOUSTON, TX 77063

PINNACLE SURGERY CENTER OF

AUSTIN LLC

130340 5125531700911 WEST 38TH STREET SUITE 400 08/31/2021 08/18/2017 08/18/2017 01/18/2018 Current

AUSTIN, TX 78705

PLANNED PARENTHOOD CENTER FOR

CHOICE ASC

130061 71353524004600 GULF FREEWAY SUITE 300 11/30/2022 11/15/2010 11/15/2010 08/10/2011 Current

HOUSTON, TX 77023

PLANNED PARENTHOOD OF GREATER

TEXAS SURGICAL HEALTH SERVICES

130193 21437318687989 W VIRGINIA DRIVE SUITE 102 07/31/2022 07/01/2014 07/01/2014 05/21/2020 Current

DALLAS, TX 75237

PLANNED PARENTHOOD OF GREATER

TEXAS SURGICAL HEALTH SERVICES

130148 81734677406464 JOHN RYAN DRIVE 05/31/2023 05/17/2013 05/17/2013 05/09/2019 Current

FORT WORTH, TX 76132

PLANNED PARENTHOOD OF GREATER

TEXAS SURGICAL HEALTH SERVICES

130121 5122750171201 E BEN WHITE BLVD SUITE A 08/31/2022 08/31/2012 09/04/2012 10/23/2018 Current

AUSTIN, TX 78704

PLANNED PARENTHOOD SOUTH

TEXAS SURGICAL CENTER

130241 21073622622140 BABCOCK ROAD SUITE 100 06/30/2023 06/26/2015 06/26/2015 06/14/2018 Current

SAN ANTONIO, TX 78229

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

PLANO CENTER FOR SURGICAL ARTS

LLC

007155 97262017005316 WEST PLANO PARKWAY 02/28/2022 02/14/2000 02/14/2000 05/24/2019 Current

PLANO, TX 75093

PLATINUM SURGERY CENTER000380 95638960002220 PEASE STREET 04/30/2023 04/22/1998 04/22/1998 03/29/2007 Current

HARLINGEN, TX 78550

PRECINCT AMBULATORY SURGERY

CENTER LLC

130171 81736939951717 PRECINCT LINE ROAD #101 12/31/2021 12/01/2013 12/01/2013 12/17/2019 Current

HURST, TX 76054

PRECISION AMBULATORY SURGERY

CENTER LLC

130476 81774178789439 NORTH BEACH ST 04/30/2022 04/30/2020 04/30/2020 04/30/2020 Current

FORT WORTH, TX 76244

PRECISION SURGERY CENTER LLC130457 90330607111802 MOORES LANE SUITE 200 01/31/2022 01/06/2020 01/06/2020 01/06/2020 Current

TEXARKANA, TX 75503

PREMIER SURGICAL PAVILION OF

SUGAR LAND

130390 28149469036350 HIGHWAY 90A SUITE 700 06/30/2022 06/04/2018 06/04/2018 06/04/2018 Current

SUGAR LAND, TX 77478

PRESTON SURGERY CENTER, LLC130165 21438741007589 PRESTON ROAD SUITE 100 10/31/2021 10/17/2013 10/17/2013 10/17/2013 Current

FRISCO, TX 75034

PROFFER SURGICAL CENTER130433 80651363871611 WALLACE BLVD. STE. 100 05/31/2023 05/09/2019 05/09/2019 05/09/2019 Current

AMARILLO, TX 79106

PROVINCIAL PARK SURGERY CENTER130100 713554635021300 PROVINCIAL BLVD SUITE 200 01/31/2022 01/30/2012 01/30/2012 01/29/2020 Current

KATY, TX 77450

PSA AMBULATORY SURGERY CENTER

OF KILLEEN LLC

130208 25441576732701 E. STAN SCHLUETER LOOP 10/31/2022 10/21/2014 10/21/2014 01/10/2018 Current

KILLEEN, TX 76542

PSA AMBULATORY SURGICAL CENTER

OF AUSTIN LLC

008505 51283612004100 DUVAL ROAD BLDG III SUITE 100 04/30/2023 04/27/2007 04/27/2007 05/06/2019 Current

AUSTIN, TX 78759

RAIDER SURGICAL CENTER LLC130305 95696831711400 E RIDGE ROAD SUITE 3 09/30/2022 09/09/2016 09/09/2016 09/09/2016 Current

MCALLEN, TX 78503-1536

REGENERATIVE SURGICAL130428 34635440803534 VISTA ROAD 01/31/2023 02/01/2019 04/02/2019 02/01/2019 Current

PASADENA, TX 77504

REGIONAL PLASTIC SURGERY CENTER

- SHERMAN

130449 90389363111111 SARA SWAMY DRIVE SUITE B 09/30/2021 09/30/2017 09/30/2017 11/05/2019 Current

SHERMAN, TX 75090

RHYTHM ENDOVASCULAR & HEART

ASC

130533 21096182825418 N LOOP 1604 W SUITE 250A 05/31/2023 05/12/2021 05/12/2021 05/12/2021 Current

Page 27 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

SAN ANTONIO, TX 78249

RICELAND SURGERY CENTER130268 4099815500390 NORTH 11TH STREET 10/31/2021 10/16/2015 10/16/2015 11/24/2015 Current

BEAUMONT, TX 77702

RIDGEWOOD ORTHOPAEDIC SURGERY

CENTER OF SAN ANTONIO

130515 210489727819138 N US HWY 281 SUITE 300 12/31/2022 12/16/2020 12/16/2020 12/16/2020 Current

SAN ANTONIO, TX 78258

RIO GRANDE REGIONAL HOSPITAL

OUTPATIENT SURGERY CENTER

130181 95663260001809 SOUTH CYNTHIA STREET 03/31/2022 03/01/2014 03/03/2014 03/07/2016 Current

MCALLEN, TX 78503

RIVER OAKS ENDOSCOPY CENTER008576 93649436361501 RIVER POINTE DRIVE SUITE 260 10/31/2021 10/22/2007 10/22/2007 10/22/2007 Current

CONROE, TX 77304

RIVER OAKS SURGERY CENTER OF

OAKBEND HEALTH SYSTEM

130274 71362685004120 SOUTHWEST FREEWAY SUITE

100

10/31/2021 11/01/2015 11/01/2015 12/17/2015 Current

HOUSTON, TX 77027

ROBERT B GREEN AMBULATORY

SURGERY CENTER

130151 2103582000903 WEST MARTIN STREET 06/30/2021 06/26/2013 06/26/2013 06/26/2013 Current

SAN ANTONIO, TX 78207

ROC ASC, LLP130073 28195383211200 BINZ STREET SUITE 101 01/31/2023 01/04/2011 01/04/2011 01/04/2011 Current

HOUSTON, TX 77004

RUSHLAND PARK SURGICENTER LP000304 80679133774404 6TH STREET 12/31/2021 12/08/1994 12/08/1994 01/13/2020 Current

LUBBOCK, TX 79416

SAME DAY SURGICARE130217 8177846771350 E. INTERSTATE 20 SUITE 200 01/31/2023 01/30/2015 01/30/2015 01/10/2020 Current

ARLINGTON, TX 76018

SAN ANTONIO CHILDRENS SURGICAL130199 21071424888706 FREDERICKSBURG ROAD SUITE

104

08/31/2022 08/20/2014 08/20/2014 08/20/2014 Current

SAN ANTONIO, TX 78240

SAN ANTONIO ENDOSCOPY CENTER008225 21061572328550 DATAPOINT SUITE 100 06/30/2023 06/02/2005 06/02/2005 05/16/2007 Current

SAN ANTONIO, TX 78229

SAN ANTONIO EYE SURGICENTER130507 2102266169715 CAMDEN STREET 11/30/2022 11/04/2020 11/04/2020 11/04/2020 Current

SAN ANTONIO, TX 78215

SAN ANTONIO GASTROENTEROLOGY

ENDOSCOPY CENTER NORTH

008496 2104919998150 EAST SONTERRA BLVD SUITE 110 04/30/2023 04/05/2007 04/05/2007 03/27/2015 Current

SAN ANTONIO, TX 78258

SAN ANTONIO GASTROENTEROLOGY

ENDOSCOPY CENTER- MED CENTER

130097 21058192902833 BABCOCK RD, SUITE 120 11/30/2021 11/22/2011 11/22/2011 01/13/2021 Current

SAN ANTONIO, TX 78229

SAN MARCOS SURGERY CENTER130150 51275479991891 MEDICAL PARKWAY 06/30/2023 06/01/2013 06/01/2013 04/26/2021 Current

Page 28 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

SAN MARCOS, TX 78666

SARATOGA SURGICAL CENTER130299 36145254606214 SARATOGA BLVD BUILDING 006 08/31/2022 08/12/2016 08/12/2016 08/12/2016 Current

CORPUS CHRISTI, TX 78414

SCOTTISH RITE FOR CHILDREN130409 46951572225700 DALLAS PARKWAY 10/31/2022 10/30/2018 10/30/2018 10/30/2018 Current

FRISCO, TX 75034

SELECT AMBULATORY SURGERY

CENTER OF FORT WORTH LLC

130265 97223447402001 COOPER STREET 10/31/2021 10/31/2015 10/31/2015 11/02/2015 Current

FORT WORTH, TX 76104

SHANNON SURGERY CENTER008641 32548658004482 SUNSET DRIVE 04/30/2022 04/03/2008 04/03/2008 03/19/2020 Current

SAN ANGELO, TX 76901

SHANNON SURGERY CENTER SOUTH130504 32522305553605 EXECUTIVE DR 10/31/2022 10/24/2020 10/24/2020 01/15/2021 Current

SAN ANGELO, TX 76904

SIMMONS AMBULATORY SURGERY

CENTER

008433 21459017734900 HARRY HINES BLVD 12/31/2022 12/08/2006 12/08/2006 12/23/2010 Current

DALLAS, TX 75235

SONTERRA PROCEDURE CENTER130133 2102818314225 E. SONTERRA BLVD SUITE 101 11/30/2022 11/13/2012 11/13/2012 01/16/2019 Current

SAN ANTONIO, TX 78258

SOUTH AUSTIN SURGERY CENTER130296 51244078944207 JAMES CASEY SUITE 203 08/31/2022 08/03/2016 08/03/2016 08/05/2016 Current

AUSTIN, TX 78745

SOUTH PLAINS ENDOSCOPY CENTER000278 80679710153610 24TH STREET 03/31/2023 03/24/1994 03/24/1994 03/01/2007 Current

LUBBOCK, TX 79410

SOUTH PLAINS SURGERY CENTER130399 80645150054412 6TH STREET 08/31/2022 08/27/2018 08/27/2018 08/27/2018 Current

LUBBOCK, TX 79416

SOUTH SHORE SURGICENTER LLC130038 28153866002622 MARINA BAY DRIVE 04/30/2022 04/26/2010 04/26/2010 01/02/2013 Current

LEAGUE CITY, TX 77573

SOUTH TEXAS AMBULATORY

SURGERY CENTER, PLLC

130060 21069605009238 FLOYD CURL DRIVE SUITE 100 11/30/2022 11/15/2010 11/15/2010 12/08/2010 Current

SAN ANTONIO, TX 78240

SOUTH TEXAS EYE SURGICENTER INC000144 36157801074406 NORTH LAURENT STREET 12/31/2022 01/01/1986 01/01/1986 12/09/2010 Current

VICTORIA, TX 77901

SOUTH TEXAS SPINE & SURGICAL

OUTPATIENT CENTER

130183 210880989718518 HARDY OAK BLVD SUITE 100 02/28/2022 02/05/2014 03/11/2014 07/31/2020 Current

SAN ANTONIO, TX 78258

SOUTH TEXAS SURGICAL HOSPITAL

OUTPATIENT CENTER

008062 36198651005837 SPOHN DRIVE 05/31/2023 05/07/2004 05/07/2004 05/16/2007 Current

CORPUS CHRISTI, TX 78413

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

SOUTH TEXAS SURGICAL INSTITUTE130350 21020063928122 DATAPOINT DRIVE SUITE 105 10/31/2021 10/10/2017 10/10/2017 12/03/2019 Current

SAN ANTONIO, TX 78229

SOUTHEAST SURGICENTER INC007867 713474141412811 BEAMER ROAD 08/31/2022 08/23/2002 08/23/2002 09/17/2020 Current

HOUSTON, TX 77089

SOUTHSIDE SPECIALTY SURGICAL

CENTER LLC

130461 36140031686005 HOLLY ROAD 01/31/2022 01/27/2020 01/27/2020 01/27/2020 Current

CORPUS CHRISTI, TX 78412

SOUTHWEST ENDOSCOPY & SURGERY

CENTER LTD

008364 8172939292701 EAST RENDON-CROWLEY ROAD 05/31/2022 05/17/2006 05/17/2006 06/17/2020 Current

BURLESON, TX 76028

SOUTHWEST FORT WORTH

ENDOSCOPY CENTER

130286 81742328886317 HARRIS PARKWAY SUITE 100 04/30/2022 04/13/2016 04/13/2016 04/13/2016 Current

FORT WORTH, TX 76132

SOUTHWESTERN WOMENS SURGERY

CENTER LP

130019 21474293108616 GREENVILLE AVENUE SUITE 101 10/31/2021 10/02/2009 10/02/2009 10/02/2009 Current

DALLAS, TX 75243

SPECIALTY SURGERY CENTER008277 21061460595255 PRUE ROAD SUITE 100 09/30/2021 09/26/2005 09/26/2005 01/28/2019 Current

SAN ANTONIO, TX 78240

SPICEWOOD SURGERY CENTER130448 713253890213617 CALDWELL DRIVE SUITE 200 10/31/2021 10/15/2019 10/15/2019 10/22/2019 Current

AUSTIN, TX 78750

SPINECARE LLP008169 36165311255734 SPOHN DRIVE SUITE B 02/28/2023 02/04/2005 02/04/2005 02/07/2011 Current

CORPUS CHRISTI, TX 78414

SPINETECH SURGERY CENTER LLC130332 4092995281950 NORTH 11TH STREET 04/30/2023 05/24/2017 04/28/2017 05/06/2019 Current

BEAUMONT, TX 77702

SPORTSORTHO SURGERY CENTER130384 9562323088610 KAMALI DRIVE 04/30/2022 04/25/2018 04/25/2018 04/25/2018 Current

HARLINGEN, TX 78550

ST DAVIDS AUSTIN SURGERY CENTER130388 512901834012200 RENFERT WAY SUITE G-2 05/31/2022 05/21/2018 05/21/2018 05/21/2018 Current

AUSTIN, TX 78758

ST MARY AMBULATORY SURGERY

CENTER

130477 28157380881006 WINDSOR LAKES BLVD STE 100 05/31/2022 05/04/2020 05/04/2020 05/04/2020 Current

CONROE, TX 77384

STONE OAK SURGERY CENTER LLC130093 2102671374123 NORTH LOOP 1604 EAST SUITE 107 10/31/2021 10/13/2011 10/13/2011 01/07/2021 Current

SAN ANTONIO, TX 78232

STONEBRIDGE SURGERY CENTER130111 97263238008855 SYNERGY DRIVE 05/31/2022 05/15/2012 05/15/2012 05/15/2012 Current

MCKINNEY, TX 75070

STONEGATE SURGERY CENTER LP008385 51243973002501 WEST WILLIAM CANNON DRIVE

SUITE 301

08/31/2022 08/17/2006 08/17/2006 07/25/2008 Current

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

AUSTIN, TX 78745

STRICTLY PEDIATRICS SURGERY

CENTER

008487 51247473371301 BARBARA JORDAN BLVD SUITE

100

03/31/2023 03/26/2007 03/26/2007 02/17/2011 Current

AUSTIN, TX 78723

SUGAR LAND SURGERY CENTER008373 281274667015300 SOUTHWEST FREEWAY SUITE

100

06/30/2022 06/16/2006 06/16/2006 05/14/2008 Current

SUGAR LAND, TX 77478

SUMMIT AMBULATORY SURGERY

CENTER

007253 71362249954126 SOUTHWEST FREEWAY SUITE

108

12/31/2021 12/21/2000 12/21/2000 12/30/2019 Current

HOUSTON, TX 77027

SURGCENTER OF GREATER DALLAS

LLC

130446 469563893211411 E NORTHWEST HIGHWAY SUITE

220

10/31/2021 10/07/2019 10/07/2019 10/07/2019 Current

DALLAS, TX 75218

SURGCENTER OF PLANO LLC130194 46920970546101 WINDHAVEN PARKWAY, SUITE

195

07/31/2022 07/10/2014 07/10/2014 07/10/2014 Current

PLANO, TX 75093-8271

SURGERY CENTER 121 LLC130424 97240311109955 GILLESPIE DRIVE SUITE 200 02/28/2023 02/07/2019 02/07/2019 02/07/2019 Current

PLANO, TX 75025

SURGERY CENTER OF AMARILLO130348 80641888701010 SOUTH COULTER STREET 10/31/2021 10/06/2017 10/06/2017 10/06/2017 Current

AMARILLO, TX 79106

SURGERY CENTER OF BOERNE130426 8303317700112 HERFF ROAD SUITE 200 03/31/2023 03/18/2019 03/18/2019 03/18/2019 Current

BOERNE, TX 78006

SURGERY CENTER OF NORTH TEXAS

PLLC

130498 2148311300330 STANDRIDGE BLVD 10/31/2022 10/14/2020 10/14/2020 10/14/2020 Current

ANNA, TX 75409

SURGERY CENTER OF NORTHEAST

TEXAS

130102 90379221081902 MOORES LANE, SUITE B 03/31/2022 03/01/2012 03/16/2012 03/20/2012 Current

TEXARKANA, TX 75503

SURGERY CENTER OF PLANO130236 97251911004005 W 15TH ST 05/31/2023 05/01/2015 05/01/2015 05/01/2015 Current

PLANO, TX 75093

SURGERY CENTER OF TEXAS130078 97254324646020 WEST PLANO PARKWAY 02/28/2023 02/14/2011 02/14/2011 02/22/2011 Current

PLANO, TX 75093

SURGERY CENTER OF THE

WOODLANDS

130416 26710 1-45 NORTH SUITE B-100 11/30/2022 11/27/2018 01/08/2019 11/27/2018 Current

SPRING, TX 77386

SURGEYECARE GENERAL

PARTNERSHIP

007861 21436114435421 LA SIERRA DRIVE 07/31/2022 07/02/2002 07/02/2002 07/29/2020 Current

DALLAS, TX 75231

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

SURGICAL AND DIAGNOSTIC CENTER

LP

007186 8172821001729 BEDFORD EULESS ROAD WEST

SUITE 100

06/30/2021 06/08/2000 06/08/2000 08/22/2019 Current

HURST, TX 76053

SURGICAL ARTS CENTER007132 21030856816501 BLANCO ROAD 11/30/2021 12/01/1999 12/01/1999 10/03/2007 Current

SAN ANTONIO, TX 78216

SURGICAL CENTER OF EL PASO007330 91553384121815 NORTH STANTON STREET 06/30/2023 06/13/2001 06/13/2001 01/16/2009 Current

EL PASO, TX 79902

SURGICAL CENTERS OF NORTH TEXAS130499 81786517712400 MATLOCK ROAD 10/31/2022 10/14/2020 10/14/2020 10/14/2020 Current

ARLINGTON, TX 76015

SURGICAL EYE CENTER OF SAN

ANTONIO, LLC

130203 210447720011601 TOPPERWEIN ROAD SUITE 2020 09/30/2022 09/05/2014 09/05/2014 09/05/2014 Current

SAN ANTONIO, TX 78233

SURGICARE OF SOUTH AUSTIN007954 51241660064307 JAMES CASEY STREET 06/30/2021 06/09/2003 06/09/2003 09/02/2014 Current

AUSTIN, TX 78745

SURGISTAR LP130031 21443142448315 WALNUT HILL LANE SUITE 110 02/28/2022 02/05/2010 02/05/2010 01/06/2020 Current

DALLAS, TX 75231

TEXAN PROCEDURE CENTER LLC130395 91528832247924 GATEWAY EAST BOULEVARD

#150 J

07/31/2022 07/24/2018 07/24/2018 07/24/2018 Current

EL PASO, TX 79915

TEXAN SURGERY CENTER007965 51234209007000 NORTH MOPAC SUITE 120 07/31/2022 07/03/2003 07/03/2003 06/10/2008 Current

AUSTIN, TX 78731

TEXARKANA SURGERY CENTER006923 90379348725404 SUMMERHILL ROAD 03/31/2022 03/02/1999 03/02/1999 02/21/2008 Current

TEXARKANA, TX 75503

TEXAS AMBULATORY SURGICAL

CENTER

008118 71388035402505 N SHEPHERD DR SUITE 101 09/30/2021 09/22/2004 09/22/2004 05/25/2021 Current

HOUSTON, TX 77008

TEXAS CENTER FOR INTERVENTIONAL

SURGERY LLC

130326 97273300144450 SOJOURN DRIVE SUITE 200 04/30/2023 04/05/2017 04/05/2017 04/05/2017 Current

ADDISON, TX 75001

TEXAS ENDOSCOPY130198 97247392926405 WEST PARKER ROAD SUITE 370 06/30/2022 06/01/2014 06/01/2014 06/01/2014 Current

PLANO, TX 75093

TEXAS ENDOSCOPY AT

INDEPENDENCE MEDICAL VILLAGE

130223 97290830008080 INDEPENDENCE PARKWAY SUITE

160

01/31/2023 01/29/2015 01/29/2015 01/29/2015 Current

PLANO, TX 75025

TEXAS EYE SURGERY CENTER LLC008515 81755402001872 NORWOOD DRIVE SUITE 100 05/31/2023 05/29/2007 05/29/2007 11/28/2018 Current

HURST, TX 76054

TEXAS GI ENDOSCOPY CENTER008615 97227035902704 NORTH GALLOWAY SUITE 102 01/31/2022 01/10/2008 01/10/2008 12/16/2019 Current

Page 32 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

MESQUITE, TX 75150

TEXAS HEALTH CRAIG RANCH

SURGERY CENTER LLC

130145 97252156008080 STATE HIGHWAY 121 SUITE 100 04/30/2023 04/08/2013 04/24/2013 04/08/2013 Current

MCKINNEY, TX 75070

TEXAS HEALTH HUGULEY SURGERY

CENTER

130361 817615440012001 SOUTH FREEWAY SUITE 101 01/31/2022 01/15/2018 01/15/2018 02/05/2018 Current

BURLESON, TX 76028

TEXAS HEALTH JOINT REPLACEMENT

SURGERY CENTER

130484 83371207566317 HARRIS PARKWAY SUITE 200 05/31/2022 05/22/2020 05/22/2020 05/27/2020 Current

FORT WORTH, TX 76132

TEXAS HEALTH ORTHOPEDIC

SURGERY CENTER - FLOWER MOUND

130157 46924085405000 LONG PRAIRIE ROAD SUITE 202 08/31/2021 08/30/2013 08/30/2013 11/08/2016 Current

FLOWER MOUND, TX 75028

TEXAS HEALTH ORTHOPEDIC

SURGERY CENTER HERITAGE

130400 68231264649848 NORTH BEACH STREET 09/30/2022 09/06/2018 09/06/2018 09/06/2018 Current

FORT WORTH, TX 76244

TEXAS HEALTH OUTPATIENT SURGERY

CENTER FORT WORTH

130107 8172507007800 5TH AVENUE SUITE 200 02/28/2022 02/29/2012 03/07/2012 02/29/2012 Current

FORT WORTH, TX 76104

TEXAS HEALTH SPINE SURGERY

CENTER ALLEN LLC

130374 81744293001120 RAINTREE CIRCLE SUITE 100 03/31/2022 03/14/2018 03/14/2018 03/14/2018 Current

ALLEN, TX 75013

TEXAS HEALTH SPINE SURGERY

CENTER ALLIANCE LLC

130465 817930500210900 FOUNDERS WAY SUITE 100 02/28/2022 02/05/2020 02/05/2020 02/05/2020 Current

FORT WORTH, TX 76244

TEXAS HEALTH SURGERY CENTER

ADDISON

130095 972913771517980 DALLAS PARKWAY SUITE 100 10/31/2021 10/26/2011 10/26/2011 08/06/2014 Current

DALLAS, TX 75287

TEXAS HEALTH SURGERY CENTER

ALLIANCE

130346 877410629010840 TEXAS HEALTH TRAIL SUITE

100

09/30/2021 09/18/2017 09/18/2017 09/18/2017 Current

FORT WORTH, TX 76244

TEXAS HEALTH SURGERY CENTER

ARLINGTON

000100 8178609933918 NORTH DAVIS DRIVE 12/31/2022 01/01/1986 01/01/1986 09/14/2016 Current

ARLINGTON, TX 76012

TEXAS HEALTH SURGERY CENTER

BEDFORD

130334 68250389401605 AIRPORT FREEWAY SUITE 100 05/31/2023 05/26/2017 05/26/2017 05/26/2017 Current

BEDFORD, TX 76021

TEXAS HEALTH SURGERY CENTER

CLEBURNE

008560 81764508112010 WEST KATHERINE P RAINES

SUITE 100

09/30/2021 09/17/2007 09/17/2007 12/30/2013 Current

CLEBURNE, TX 76033

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

TEXAS HEALTH SURGERY CENTER

DALLAS

000163 21489104667150 GREENVILLE AVENUE SUITE 200 11/30/2022 11/05/1986 11/05/1986 11/30/2010 Current

DALLAS, TX 75231

TEXAS HEALTH SURGERY CENTER

DENTON

130537 94038371002515 SCRIPTURE STREET 06/30/2023 06/01/2021 06/01/2021 06/01/2021 Current

DENTON, TX 76201

TEXAS HEALTH SURGERY CENTER

DENTON

008295 9403837100207 NORTH BONNIE BRAE 11/30/2021 11/10/2005 11/10/2005 10/14/2019 Current

DENTON, TX 76201

TEXAS HEALTH SURGERY CENTER

FORT WORTH MIDTOWN

000121 81787747772001 WEST ROSEDALE 12/31/2021 01/01/1987 01/01/1987 12/03/2019 Current

FORT WORTH, TX 76104

TEXAS HEALTH SURGERY CENTER

IRVING LLC

130398 97243852322120 NORTH MACARTHUR BLVD.

SUITE 200

08/31/2022 08/08/2018 08/27/2018 01/14/2020 Current

IRVING, TX 75061

TEXAS HEALTH SURGERY CENTER

PARK HILL

130222 81758519003455 LOCKE AVENUE 01/31/2023 01/28/2015 01/28/2015 05/26/2017 Current

FORT WORTH, TX 76107

TEXAS HEALTH SURGERY CENTER

PRESTON PLAZA

008328 972267540017950 PRESTON ROAD SUITE 75 02/28/2022 02/22/2006 02/22/2006 03/02/2015 Current

DALLAS, TX 75252

TEXAS HEALTH SURGERY CENTER

ROCKWALL

130381 97284514693144 HORIZON ROAD SUITE 120 04/30/2022 04/10/2018 04/10/2018 04/10/2018 Current

ROCKWALL, TX 75032

TEXAS HEALTH SURGERY CENTER

WAXAHACHIE LLC

130535 83336412011434 W US HWY 287 BYPASS SUITE 100 05/31/2023 05/19/2021 05/19/2021 05/19/2021 Current

WAXAHACHIE, TX 75165

TEXAS INTERNATIONAL ENDOSCOPY

CENTER

130155 71352084326620 MAIN STREET, SUITE 1500 05/31/2023 05/01/2013 08/05/2013 05/01/2013 Current

HOUSTON, TX 77030

TEXAS MIDWEST ENDOSCOPY

CENTER LLC

130488 325232659614 HOSPITAL DRIVE SUITE B 06/30/2022 06/22/2020 06/22/2020 06/22/2020 Current

ABILENE, TX 79606

TEXAS MIDWEST SURGERY CENTER007182 3256776555751 NORTH 18TH STREET 05/31/2023 05/24/2000 05/24/2000 04/24/2007 Current

ABILENE, TX 79601

TEXAS ORTHOPEDICS SURGERY

CENTER

007846 51243910064700 SETON CENTER PARKWAY SUITE

100

04/30/2023 04/24/2002 04/24/2002 04/17/2007 Current

AUSTIN, TX 78759

TEXAS PARTNERS CENTER130526 81790597613304 COLORADO AVENUE SUITE 203 03/31/2023 03/04/2021 03/04/2021 03/04/2021 Current

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

DENTON, TX 76210

TEXAS PEDIATRIC SURGERY CENTER006971 81725510504375 BOOTH CALLOWAY ROAD SUITE

100

05/31/2022 05/12/1999 05/12/1999 04/11/2008 Current

NORTH RICHLAND HILLS, TX 76180

TEXAS PRECISION SURGERY CENTER130240 36133413005721 ESPLANADE DRIVE 06/30/2023 06/09/2015 06/09/2015 09/11/2020 Current

CORPUS CHRISTI, TX 78414

TEXAS SURGICAL CENTER130106 43269942245609 DEAUVILLE BLVD. 12/31/2021 12/31/2011 03/05/2012 12/31/2011 Current

MIDLAND, TX 79706

TEXOMA OUTPATIENT SURGERY

CENTER INC

000317 94072324991712 ELEVENTH STREET 06/30/2022 10/18/1994 10/18/1994 05/14/2008 Current

WICHITA FALLS, TX 76301

TEXOMA VALLEY SURGERY CENTER

LP

007256 90389305001419 B NORTH TRAVIS 01/31/2023 01/05/2001 01/05/2001 12/07/2010 Current

SHERMAN, TX 75092

THE AMBULATORY SURGICAL CENTER

(ASC) AT LBJ

130182 71356692455550 KELLEY ST. 3RD FLOOR 03/31/2022 03/04/2014 03/04/2014 02/11/2020 Current

HOUSTON, TX 77026

THE CATARACT CENTER OF EAST

TEXAS

007870 9035954333802 TURTLE CREEK DRIVE 09/30/2021 09/03/2002 09/03/2002 08/07/2019 Current

TYLER, TX 75701

THE CENTER FOR CARDIOVASCULAR

EXCELLENCE

130471 888785731025450 KUYKENDAHL SUITE 110 04/30/2022 04/10/2020 04/10/2020 04/10/2020 Current

TOMBALL, TX 77375

THE CENTER FOR SIGHT000272 93663484342 MEDICAL CENTER BOULEVARD 09/30/2021 09/14/1993 09/14/1993 09/05/2007 Current

LUFKIN, TX 75904

THE CENTER FOR SPECIAL SURGERY

AT TCA

130174 210575570021 SPURS LANE SUITE SL-100 02/28/2022 02/01/2014 02/04/2014 02/01/2014 Current

SAN ANTONIO, TX 78240

THE CLINIC FOR SPECIAL SURGERY000395 8173353668900 12TH AVENUE 03/31/2022 03/19/1998 03/19/1998 02/19/2008 Current

FORT WORTH, TX 76104

THE ENDOSCOPY CENTER007865 9792920033109 PARKING WAY 08/31/2022 08/13/2002 08/13/2002 07/16/2008 Current

LAKE JACKSON, TX 77566

THE ENDOSCOPY CENTER OF

TEXARKANA

008336 90379186571920 MOORES LANE SUITE B 03/31/2022 03/16/2006 03/16/2006 02/01/2008 Current

TEXARKANA, TX 75503

THE HEART & VASCULAR SURGERY

CENTER

130218 97948599223201 UNIVERSITY DR. E, SUITE 430 01/31/2023 01/20/2015 01/20/2015 01/20/2015 Current

BRYAN, TX 77802

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

THE OCULAR SURGERY CENTER LLC000175 21022221541100 NORTH MAIN AVENUE 05/31/2022 05/08/1987 05/08/1987 05/08/2008 Current

SAN ANTONIO, TX 78212

THE SAN ANTONIO

GASTROENTEROLOGY ENDOSCOPY

CENTER

007982 2102710606520 EAST EUCLID AVENUE 08/31/2021 08/25/2003 08/25/2003 07/21/2011 Current

SAN ANTONIO, TX 78212

THE SURGERY CENTER008190 36157083116370 NORTH NAVARRO 03/31/2023 03/30/2005 03/30/2005 02/17/2011 Current

VICTORIA, TX 77904

THE SURGERY CENTER AT GASLIGHT

MEDICAL PARK

008517 9366378771117 GASLIGHT MEDICAL PARKWAY 06/30/2021 06/04/2007 06/04/2007 06/04/2007 Current

LUFKIN, TX 75904

THE SURGERY CENTER OF

NACOGDOCHES

007163 93656835954948 N E STALLINGS DRIVE 03/31/2022 03/23/2000 03/23/2000 02/22/2008 Current

NACOGDOCHES, TX 759651265

THE SURGICAL CENTER OF MIDLAND000398 43269465172706 WEST CUTHBERT BLDG A 10/31/2021 10/16/1998 10/16/1998 10/14/2019 Current

MIDLAND, TX 79701

THEDA OAKS GASTROENTEROLOGY

AND ENDOSCOPY CENTER LTD

008032 210268010019226 STONEHUE SUITE 103 02/28/2023 02/20/2004 02/20/2004 02/14/2011 Current

SAN ANTONIO, TX 78258

THR/STT ROCKWALL ASC, LLC130262 97272243113140 HORIZON ROAD 10/31/2021 10/12/2015 10/12/2015 10/12/2015 Current

ROCKWALL, TX 75032

THR/STT SOUTHLAKE, ASC LLC130119 8174429300290 MIRON DRIVE 06/30/2022 06/01/2012 07/26/2012 06/01/2012 Current

SOUTHLAKE, TX 76092

TOTAL VASCULAR CARE130337 2105473430215 NORTH SAN SABA STREET SUITE

201

08/31/2021 08/07/2017 08/07/2017 08/07/2017 Current

SAN ANTONIO, TX 78207

TOWNSEN MEMORIAL SURGERY

CENTER - MED CENTER

130492 346701800010005 S MAIN ST 07/31/2022 07/20/2020 07/20/2020 07/28/2020 Current

HOUSTON, TX 77025

TOWNSEN MEMORIAL SURGERY

CENTER - SPRING

130536 34626203003301 SPRING STUEBNER RD #100 05/31/2023 06/01/2021 06/01/2021 05/21/2021 Current

SPRING, TX 77389

TRINITY PARK SURGERY CENTER008609 81737593703501 MATLOCK ROAD 01/31/2022 01/03/2008 01/03/2008 01/03/2008 Current

ARLINGTON, TX 76015

TURTLE CREEK SURGERY CENTER LLC008054 9035921664801 TURTLE CREEK DRIVE 04/30/2023 04/28/2004 04/28/2004 04/17/2007 Current

TYLER, TX 75701

TUSCAN SURGERY CENTER AT LAS

COLINAS LLC

130075 2144421900701 TUSCAN DRIVE SUITE 100 12/31/2022 12/07/2010 01/21/2011 10/26/2020 Current

Page 36 of 396/9/2021

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License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

IRVING, TX 75039

TWIN CREEKS SURGERY CENTER130425 97287284042023 WEST MCDERMOTT DRIVE

SUITE 240

02/28/2023 02/21/2019 02/21/2019 02/21/2019 Current

ALLEN, TX 75013

TYLER CARDIAC AND

ENDOVASCULAR SURGERY CENTER

130221 90353540001767 TROUP HIGHWAY 01/31/2023 01/23/2015 01/23/2015 01/23/2015 Current

TYLER, TX 75701

UH COLLEGE OF OPTOMETRY

SURGERY CENTER

130125 71374371414849 CALHOUN ROAD SUITE 100 09/30/2022 09/26/2012 09/26/2012 09/01/2015 Current

HOUSTON, TX 77204

UNITED MINIMALLY INVASIVE

SURGERY CENTER LLC

130514 21068631872116 BABCOCK RD 12/31/2022 12/11/2020 12/11/2020 12/11/2020 Current

SAN ANTONIO, TX 78229

UNIVERSITY HEALTH SYSTEM

SURGERY CENTER - MEDICAL CENTER

130163 21035820008300 FLOYD CURL DRIVE 10/31/2021 10/01/2013 10/01/2013 10/01/2013 Current

SAN ANTONIO, TX 78229

UNIVERSITY MEDICAL CENTER OF EL

PASO

130503 91520026504642 NORTH MESA 10/31/2022 10/20/2020 10/20/2020 10/20/2020 Current

EL PASO, TX 79912

UNIVERSITY SURGERY CENTER008273 71379548851107 BANKS STREET 09/30/2021 09/15/2005 09/15/2005 08/07/2019 Current

HOUSTON, TX 77006

US CARDIO OF SA LLC130228 21080243506830 HEUERMANN ROAD 03/31/2023 03/02/2015 03/02/2015 03/02/2015 Current

SAN ANTONIO, TX 78256

UT HEALTH AUSTIN AMBULATORY

SURGERY CENTER

130489 51249552371601 TRINITY ST BLDG A SUITE 1.106 06/30/2022 06/25/2020 06/25/2020 06/25/2020 Current

AUSTIN, TX 78712

VALLEY AMBULATORY SURGICAL

CENTER

130264 9568430032901 NORTH JACKSON ROAD 10/31/2021 10/15/2015 10/15/2015 10/15/2015 Current

MCALLEN, TX 78501

VALLEY ENDOSCOPY CENTER007276 95642123243101 SOUTH 77 SUNSHINE STRIP

SUITE B

12/31/2022 01/01/2001 01/01/2001 11/18/2008 Current

HARLINGEN, TX 78550

VICTORIA SURGERY CENTER000396 8008330234105 JAMES COLEMAN DRIVE 10/31/2021 10/22/1997 10/22/1997 09/27/2007 Current

VICTORIA, TX 77904

VIKING PAIN MANAGEMENT LLC130358 83293981791229 CREEKWAY DRIVE SUITE 104 12/31/2021 12/27/2017 12/27/2017 12/27/2017 Current

SUGAR LAND, TX 77478

VIP SURGICAL CENTER130336 93644122331246 NORTH FM 3083 WEST SUITE A 07/31/2021 07/20/2017 07/20/2017 07/20/2017 Current

CONROE, TX 77304

Page 37 of 396/9/2021

Page 38: Profession Roster Report - Texas Health and Human Services · 2021. 6. 15. · el paso, tx 79925 130176 bay area endoscopy 444 fm 1959 suite b 2814819400 12/31/2021 12/31/2013 02/12/2014

License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

VISION PARK SURGERY CENTER LLC130456 111 VISION PARK BLVD STE. 200 01/31/2022 01/02/2020 01/02/2020 01/02/2020 Current

SHENANDOAH, TX 77394

VISTA SURGERY CENTER008597 43252058884200 ANDREWS HIGHWAY 12/31/2021 12/05/2007 12/05/2007 12/05/2007 Current

MIDLAND, TX 79703

VISTA SURGERY CENTER LLC008654 91559543751400 COMMON DRIVE 05/31/2022 05/21/2008 05/21/2008 05/21/2008 Current

EL PASO, TX 79936

VITAL HEART AND VEIN ASC130432 281446665618450 HWY 59 SUITE 101-B 05/31/2023 05/06/2019 05/06/2019 05/06/2019 Current

HUMBLE, TX 77338

VIVERE AUSTIN SURGERY CENTER130162 51273004712200 PARK BEND DRIVE BUILDING 3

SUITE 200

09/30/2021 09/25/2013 09/25/2013 10/23/2019 Current

AUSTIN, TX 78758

WACO CARDIOLOGY CATH LAB &

SURGERY CENTER

130273 25477608007125 SANGER AVENUE SUITE E 12/31/2021 12/09/2015 12/09/2015 12/16/2019 Current

WACO, TX 76712

WACO GASTROENTEROLOGY

ENDOSCOPY CENTER

007983 2545370306364 RICHLAND WEST CIRCLE SUITE B 09/30/2022 09/03/2003 09/03/2003 08/07/2008 Current

WACO, TX 76712

WALNUT HILL SURGERY CENTER LLC130252 21469262205494 GLEN LAKES DRIVE 08/31/2021 06/15/2015 06/15/2015 11/20/2019 Current

DALLAS, TX 75231

WATER LEAF SURGERY CENTER LTD130302 73780238385200 B DAVIS LANE SUITE 100 09/30/2022 09/02/2016 09/02/2016 09/02/2016 Current

AUSTIN, TX 78749

WATERMERE SURGERY CENTER130280 81743132002815 WEST SOUTHLAKE BLVD SUITE

100

03/31/2022 03/02/2016 03/02/2016 03/29/2016 Current

SOUTHLAKE, TX 76092

WAXAHACHIE SURGERY CENTER130443 4695052020101 YMCA DR 10/31/2022 10/15/2018 10/15/2018 03/02/2020 Current

WAXAHACHIE, TX 75165

WELLNESS AMBULATORY SURGERY

CENTER LLC

130462 46962525002719 VIRGINIA PARKWAY 01/31/2022 01/30/2020 01/30/2020 01/30/2020 Current

MCKINNEY, TX 75071

WEST EL PASO SURGICAL CENTER130478 9153522100820 E REDD ROAD BLDG C 02/28/2022 03/01/2020 03/01/2020 05/06/2020 Current

EL PASO, TX 79912

WEST GRAY CENTER FOR SPECIAL

SURGERY

130263 83238927321355 WEST GRAY STREET 10/31/2021 10/14/2015 10/14/2015 10/14/2015 Current

HOUSTON, TX 77019

WEST HOUSTON SURGERY CENTER000318 7134613547970 CAMPBELL ROAD 12/31/2022 01/01/1986 01/01/1986 11/22/2010 Current

HOUSTON, TX 77024

Page 38 of 396/9/2021

Page 39: Profession Roster Report - Texas Health and Human Services · 2021. 6. 15. · el paso, tx 79925 130176 bay area endoscopy 444 fm 1959 suite b 2814819400 12/31/2021 12/31/2013 02/12/2014

License Type Code: 6813 - Rank Code: ALL - Status Code(s): 20 - Mdf: ALL

Profession Roster Report

Order By Name

Ambulatory Surgical Center

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

WESTLAKE HILLS SURGERY CENTER

LLC

130275 51269621914701 BEE CAVE ROAD SUITE 203 01/31/2022 01/04/2016 01/04/2016 01/24/2020 Current

AUSTIN, TX 78746

WICHITA FALLS ENDOSCOPY CENTER

LP

008194 94076190341500 9TH STREET 04/30/2023 04/11/2005 04/11/2005 04/25/2007 Current

WICHITA FALLS, TX 76301

WILLIAMSON SURGERY CENTER130083 5128614200301 SETON PARKWAY SUITE 200 04/30/2023 04/12/2011 04/12/2011 04/12/2011 Current

ROUND ROCK, TX 78665

WILSON SURGICENTER007928 80679221044315 28TH STREET SUITE 2 03/31/2023 03/04/2003 03/04/2003 02/12/2009 Current

LUBBOCK, TX 79410

WINDHAVEN SURGERY CENTER LLC008561 97221274636160 WINDHAVEN PARKWAY, SUITE

220

09/30/2021 09/18/2007 09/18/2007 10/02/2019 Current

PLANO, TX 75093

WISE HEALTH PAIN MANAGEMENT

CENTER AT SOUTHLAKE

130405 81731010653075 WEST SOUTHLAKE BLVD 07/31/2022 07/05/2018 10/04/2018 07/05/2018 Current

SOUTHLAKE, TX 76092

WOMENS SPECIALTY SURGERY

CENTER OF DALLAS LLC

130013 21434567478230 WALNUT HILL LANE SUITE 101 06/30/2023 06/03/2009 06/03/2009 06/03/2011 Current

DALLAS, TX 75231

WOODLANDS ENDOSCOPY CENTER008420 9363218910111 VISION PARK BLVD SUITE 160 10/31/2022 10/26/2006 10/26/2006 09/02/2008 Current

THE WOODLANDS, TX 77384

ZAZEN SURGERY CENTER LLC130421 281869301125230 KINGSLAND BOULEVARD 01/31/2023 01/29/2019 01/29/2019 01/29/2019 Current

KATY, TX 77494

ZENITH SURGERY CENTER PLLC130493 281978224910710 KUYKENDAHL SUITE 160 09/30/2021 09/04/2019 09/04/2019 07/30/2020 Current

THE WOODLANDS, TX 77381

TOTAL - 560

Page 39 of 396/9/2021