SURGICORE LLC – NPI #1104623826
Clinic/Center

SURGICORE LLC is an AHC clinic located in SOUTHLAKE, TX. NPPES has assigned the NPI number 1104623826 to SURGICORE LLC on February 28, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was last updated on Jan 05, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SURGICORE LLC below.

NPI Profile for
SURGICORE LLC

NPI Number
1104623826
Enumeration Date

(more than a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SURGICORE LLC
Primary location
300 S NOLEN DR STE 160
SOUTHLAKE, TX 76092-8054
Phone: (941) 380-6513 Fax:
Mailing address
3207 OXFORD DR
ROWLETT, TX 75088-5938
Phone: (941) 380-6513 Fax:
Organization Subpart
No
Authorized Official
JOSHUA PUTTER
OWNER
Phone: (941) 380-6513
Updated
Certification Date
Jan 05, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.