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General NPI Number Information
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NPI Number | 1194181339
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Entity Type | Organization
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Legal Business Name | SYNERGISTIC HEALTH CARE
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Dates
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Enumeration Date | 01/04/2016
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 1930 LIVE OAK ST
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City | COMMERCE
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State | TX
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Zip | 75428-2460
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Country | US
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Telephone | 903-246-3305
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Fax | 888-217-8860
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Provider Business Mailing Address
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Address Line | PO BOX 271
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City | COMMERCE
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State | TX
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Zip | 75429-0271
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Country | US
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Telephone | 903-246-3305
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Fax | 888-217-8860
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Authorized Official
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Title or Position | OWNER
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Name | MR. SCOTT STEGALL
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Credential | PA-C
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Telephone | 903-246-3305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01268
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License Number State | TX
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