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General NPI Number Information
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NPI Number | 1780251595
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Entity Type | Organization
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Legal Business Name | SYNERGY ANESTHESIA MANAGEMENT
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 106 WESTERN BREEZE DR
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City | FORT WORTH
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State | TX
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Zip | 76126-6058
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Country | US
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Telephone | 817-296-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 106 WESTERN BREEZE DR
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City | FORT WORTH
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State | TX
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Zip | 76126-6058
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Country | US
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Telephone | 817-296-1222
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | NATHAN CRICK
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Credential |
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Telephone | 817-296-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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