Healthcare Provider Details

I. General information

NPI: 1770946238
Provider Name (Legal Business Name): SYNERGY DX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 04/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 KATY HOCKLEY CUT OFF RD
KATY TX
77493-7838
US

IV. Provider business mailing address

4610 KATY HOCKLEY CUT OFF RD
KATY TX
77493-7838
US

V. Phone/Fax

Practice location:
  • Phone: 832-962-9121
  • Fax:
Mailing address:
  • Phone: 832-962-9121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2472E0500X
TaxonomyEEG Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MARCELO DURAN
Title or Position: OWNER/ TECHINICIAN
Credential: RPGST
Phone: 832-962-9121