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General NPI Number Information
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NPI Number | 1134315955
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Entity Type | Organization
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Legal Business Name | SYNAPSE RADIOLOGY ASSOCIATE, P.A.
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Dates
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Enumeration Date | 09/16/2007
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Last Update Date | 09/16/2007
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Provider Practice Location Address
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Address Line | 1200 CHANCELLOR LN
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City | MCKINNEY
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State | TX
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Zip | 75070-9097
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Country | US
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Telephone | 972-369-8557
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Fax | 972-542-6915
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Provider Business Mailing Address
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Address Line | 1200 CHANCELLOR LN
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City | MCKINNEY
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State | TX
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Zip | 75070-9097
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Country | US
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Telephone | 972-369-8557
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Fax | 972-542-6915
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. NICHOLAS GREGORY IWASKO
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Credential | M.D.
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Telephone | 972-369-8557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | L3347
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License Number State | TX
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