MEDICARE: WATER LEAF SURGERY CENTER, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1437505948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WATER LEAF SURGERY CENTER, LTD

Provider Business Mailing Address
First Line	:	7951 SHOAL CREEK BLVD STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-7582
Country	:	US
Telephone Number	:	512-584-8404
Fax Number	:	512-834-4142

Provider Business Practice Location Address
First Line	:	5200 DAVIS LANE
Second Line	:	SUITE B100
City	:	AUSTIN
State	:	TX
Zip	:	78749
Country	:	US
Telephone Number	:	737-802-3838
Fax Number	:	512-834-4142

Authorized Official
Title or Position	:	CEO
Name	:	SANDFORD M SCHOCKET
Credential	:	MD
Telephone Number	:	512-584-8404

Provider Enumeration Date	:	05/13/2016
Last Update Date	:	04/13/2026

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