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General NPI Number Information
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NPI Number | 1447203369
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Entity Type | Organization
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Legal Business Name | SYNERGY ORTHOTICS & PROSTHETICS, LLC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 9301 N CENTRAL EXPY SUITE 230
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City | DALLAS
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State | TX
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Zip | 75231-5009
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Country | US
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Telephone | 214-239-2970
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Fax | 214-239-2974
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Provider Business Mailing Address
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Address Line | 9301 N CENTRAL EXPY SUITE 230
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City | DALLAS
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State | TX
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Zip | 75231-5009
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Country | US
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Telephone | 214-239-2970
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Fax | 214-239-2974
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | CATHERINE ANN MIZE
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Credential | CPO
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Telephone | 214-239-2970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 101197
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 101197
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License Number State | TX
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