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General NPI Number Information
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NPI Number | 1396907101
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Entity Type | Organization
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Legal Business Name | SYNERGY OUTPATIENT THERAPY SERVICES LLC
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 02/17/2014
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Provider Practice Location Address
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Address Line | 435 PAREDES LINE RD STE A
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City | BROWNSVILLE
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State | TX
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Zip | 78521
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Country | US
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Telephone | 956-544-4500
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Fax | 956-541-9839
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Provider Business Mailing Address
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Address Line | 435 PAREDES LINE RD STE A
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City | BROWNSVILLE
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State | TX
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Zip | 78521
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Country | US
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Telephone | 956-266-2114
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Fax | 956-541-9839
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. HONORATA SHIELA BARDAJE NICART
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Credential | PT
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Telephone | 956-266-2114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1127470
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License Number State | TX
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