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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MEDICAL CITY SURGERY CENTER SOUTHLAKE, LLC
NPI 1144970807
Clinic/Center - Ambulatory Surgical in Southlake, TX

Active since March 25, 2022CLIA 45D2104452 · Waiver
2815 W SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092(817) 431-3200(817) 431-3117 Get Directions Write a Review

NPPES record last updated: June 15, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Medical City Surgery Center Southlake, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDICAL CITY SURGERY CENTER SOUTHLAKE, LLC (NPI 1144970807), doing business as Medical City Surgery Center Southlake, is a healthcare organization registered as an ambulatory surgical in Southlake, Texas and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through November 3, 2027 and lists David Mcknight, Vp/cfo, as its authorized official.

NPPES Registry Identity

NPI1144970807
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameMEDICAL CITY SURGERY CENTER SOUTHLAKE, LLC
Location Address2815 W SOUTHLAKE BLVD STE 100Southlake, TX 76092-1498
Mailing Address2815 W Southlake Blvd Ste 100Southlake, TX 76092-1498 · (817) 431-3200 · Fax (817) 431-3117
Phone(817) 431-3200
Fax(817) 431-3117
Organization SubpartNo
Authorized OfficialDavid McknightVp/cfo · (972) 789-2816
Enumeration DateMarch 25, 2022
Last NPPES UpdateJune 15, 2026
NPPES CertifiedJune 15, 2026
✔ NPI 1144970807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
2815 W SOUTHLAKE BLVD STE 100, Southlake, TX 76092
Open in Google Maps ↗

Other Names 1

Doing Business AsMedical City Surgery Center Southlake

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2104452

Medical City Surgery Center Southlake · Southlake, TX
Active · expires Nov 3, 2027
CLIA Number45D2104452
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateNovember 4, 2025
Certificate Expiration DateNovember 3, 2027
Laboratory DirectorRona J. Fello
Laboratory Phone(817) 431-3200
Laboratory LocationMedical City Surgery Center Southlake2815 W Southlake Blvd Suite 100, Southlake, TX 76092
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635
This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.
93 services39 patients
Injection of lower or sacral spine facet joint using imaging guidance, single level 64493
This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.
47 services16 patients
Insertion of spinal neurostimulator electrode array through skin 63650
This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.
35 services12 patients
Injection of substance into lower spine canal using imaging guidance 62323
This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.
32 services28 patients
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483
This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.
32 services25 patients
Injection of substance into middle or upper spine canal using imaging guidance 62321
This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.
16 services13 patients

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WATERMERE SURGERY CENTER LLC
Clinic/Center (Ambulatory Surgical)
2815 W SOUTHLAKE BLVD STE 100
SOUTHLAKE, TX 76092
Tarrant County (817) 431-3200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medical City Surgery Center Southlake, LLC's NPI number?

The NPI number for Medical City Surgery Center Southlake, LLC is 1144970807. It was assigned to this organization in the NPPES registry on March 25, 2022. The provider is doing business as Medical City Surgery Center Southlake.

Where is Medical City Surgery Center Southlake, LLC located?

Medical City Surgery Center Southlake, LLC is located at 2815 W Southlake Blvd Ste 100, Southlake, TX 76092. The listed phone number is (817) 431-3200.

What is Medical City Surgery Center Southlake, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Medical City Surgery Center Southlake, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2104452) is associated with this NPI, valid through November 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Medical City Surgery Center Southlake, LLC accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 5 other insurers list Medical City Surgery Center Southlake, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Medical City Surgery Center Southlake, LLC was last updated on June 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 55 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.