Healthcare Provider Details

I. General information

NPI: 1740481753
Provider Name (Legal Business Name): SYNERGY DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10455 N CENTRAL EXPWY # 109-403
DALLAS TX
75231
US

IV. Provider business mailing address

10455 N CENTRAL EXPWY # 109-403
DALLAS TX
75231
US

V. Phone/Fax

Practice location:
  • Phone: 800-420-1481
  • Fax:
Mailing address:
  • Phone: 800-420-1481
  • Fax: 800-718-7902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM JOHN DRAGOO
Title or Position: PRESIDENT
Credential:
Phone: 800-420-1481