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General NPI Number Information
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NPI Number | 1588532204
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Entity Type | Organization
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Legal Business Name | SYNERGY SPECIALTY GROUP LLC
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Dates
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Enumeration Date | 10/24/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 1999 BRYAN ST STE 900
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City | DALLAS
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State | TX
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Zip | 75201-3140
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Country | US
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Telephone | 830-255-6561
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Fax |
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Provider Business Mailing Address
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Address Line | 500 E SHORE DR STE 223
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City | EAGLE
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State | ID
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Zip | 83616-6908
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Country | US
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Telephone | 714-353-8894
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Fax |
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | DR. SAMUEL JURCA
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Credential | DO
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Telephone | 714-353-8894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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