Epic Surgery Clinic – Surgery Physician, NPI 1174147086
Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Epic Surgery Clinic
3208 AMBER WAVES LN
WYLIE, TX 750981216
Phone: (945) 205-0333
Fax: (945) 205-0444
Type: Mailing
1600 COIT RD STE 207
PLANO, TX 750756172
Phone: (972) 833-7525
Type: Location
4108 W 15TH ST STE 200
PLANO, TX 750935850
Phone: (972) 833-7525
Type: Mailing
811 S CENTRAL EXPY STE 103
RICHARDSON, TX 750807439
Phone: (945) 205-0333
Fax: (945) 205-0444
Type: Location
1402 Medical Dr
Sulphur Springs, TX 754822199
Phone: (945) 205-0333
Fax: (945) 202-0444
Type: Location
2700 W Pleasant Run Rd
Suite 370; Physician West Bldg
Lancaster, TX 751461078
Phone: (945) 205-0333
Fax: (945) 205-0444
Type: Location
9 MEDICAL PARKWAY, PLAZA 4
SUITE 102
FARMERS BRANCH, TX 752347852
Phone: (945) 205-0333
Fax: (945) 205-0444
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-06-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-12-31 (159 days ago).
Enrollment records
1
Earliest due date
2025-12-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20200611001968 | O | Clinic/Group Practice | TX | 2025-12-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75098)
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