Healthcare Provider Details

I. General information

NPI: 1508298126
Provider Name (Legal Business Name): SYNERGY RADIOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7026 OLD KATY RD STE 276
HOUSTON TX
77024-2133
US

IV. Provider business mailing address

PO BOX 4952
HOUSTON TX
77210-4952
US

V. Phone/Fax

Practice location:
  • Phone: 713-621-7436
  • Fax: 713-963-9051
Mailing address:
  • Phone: 713-621-7436
  • Fax: 713-963-9051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code243U00000X
TaxonomyRadiology Practitioner Assistant
License Number12TX1463
License Number StateTX

VIII. Authorized Official

Name: SHARLEE LEBLEU
Title or Position: VICE PRESIDENT
Credential:
Phone: 480-321-7026