AESTHETIC ORAL & FACIAL SURGICAL CENTER OF THE SOUTHWEST, PC — NPI 1790778314 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in KELLER, TX)

CMS-1500 Box 24J / 33a • NPI

1790778314

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QS0112X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

1850 KELLER PKWY, SUITE 102, KELLER, TX, 76248-3706

✓ 9-Digit EDI 837 ZIP+4 (76248-3706)

Practice Phone & Referral Fax

(817) 431-9566

Fax: (817) 337-8687

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1790778314 (AESTHETIC ORAL & FACIAL SURGICAL CENTER OF THE SOUTHWEST, PC) 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

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1790778314` (NPI-2 Organization / Facility)
Provider / Legal Name	AESTHETIC ORAL & FACIAL SURGICAL CENTER OF THE SOUTHWEST, PC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QS0112X` (Clinic/Center, Oral and Maxillofacial Surgery)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	1850 KELLER PKWY, SUITE 102, KELLER, TX, 76248-3706
Practice Telephone / Fax	Tel: (817) 431-9566 \| Fax: (817) 337-8687
Administrative Mailing Address	1850 KELLER PKWY, KELLER, TX, 76248-3706
Enumeration & Last Sync	Enumerated: 2005-08-30 \| CMS Record Updated: 2020-08-22
Authorized Official	WILLIAM STARCK (President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1850 KELLER PKWY, SUITE 102, KELLER, TX, 76248-3706

🗺️ Open in Google Maps 🏥 More Providers in KELLER

🔒 Are you AESTHETIC ORAL & FACIAL SURGICAL CENTER OF THE SOUTHWEST, PC? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (261QS0112X)

What Does Taxonomy Code 261QS0112X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QS0112X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AESTHETIC ORAL & FACIAL SURGICAL CENTER OF THE SOUTHWEST, PC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QS0112X` — Clinic/Center, Oral and Maxillofacial Surgery Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: TX \| License: `17519` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

AESTHETIC ORAL & FACIAL SURGICAL CENTER OF THE SOUTHWEST, PC (NPI #1790778314)