CMS-1500 Box 24J / 33a • NPI
1336766393
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
261QM0801X (CMS B4[14])
Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center
Box 32 Service Location & ZIP+4
301 N PRESTON RD STE BPROSPER, PROSPER, TX, 75078-8874
✓ 9-Digit EDI 837 ZIP+4 (75078-8874)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1336766393 (3FTL) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1336766393 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | 3FTL |
| Plain-English Specialty | Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: 261QM0801X (Clinic/Center, Mental Health (Including Community Mental Health Center)) |
| Certifying / Licensing Body | Accreditation Association for Ambulatory Health Care (AAAHC) / CMS |
| Practice Location Address | 301 N PRESTON RD STE BPROSPER, PROSPER, TX, 75078-8874 |
| Practice Telephone / Fax | Tel: (972) 347-1320 |
| Administrative Mailing Address | 1116 MACGREGOR LN, GUNTER, TX, 75058-4253 |
| Enumeration & Last Sync | Enumerated: 2020-06-25 | CMS Record Updated: 2020-06-25 |
| Authorized Official | JENNIFER HALLEY (Owner) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (261QM0801X)
What Does Taxonomy Code 261QM0801X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QM0801X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (3FTL)
Typical CPT / Diagnostic Procedures:- Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
- Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures
- Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101YM0800X — Counselor, Mental HealthPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor | State: N/A | License: Verified | Primary: Secondary |
103T00000X — PsychologistPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist | State: N/A | License: Verified | Primary: Secondary |
171M00000X — Case Manager/Care CoordinatorPlain English: Licensed & Credentialed Case Manager/Care Coordinator | State: N/A | License: Verified | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: N/A | License: Verified | Primary: Secondary |
363LP2300X — Nurse Practitioner, Primary CarePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care | State: N/A | License: Verified | Primary: Secondary |
261QM0801X — Clinic/Center, Mental Health (Including Community Mental Health Center)Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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