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General NPI Number Information
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NPI Number | 1407692817
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Entity Type | Organization
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Legal Business Name | SYNOVA HEALTH
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Dates
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Enumeration Date | 07/04/2024
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 5656 BEE CAVES RD STE F201
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5236
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Country | US
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Telephone | 512-492-5755
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Fax | 512-727-3982
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Provider Business Mailing Address
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Address Line | 5656 BEE CAVES RD STE F201
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5236
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Country | US
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Telephone | 512-492-5755
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Fax | 512-727-3982
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Authorized Official
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Title or Position | MANAGER
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Name | MR. GABRIEL L PETTY
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Credential | PA-C
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Telephone | 512-492-5755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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