MEDICARE: SYNRG PERFORMANCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1083450241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNRG PERFORMANCE

Provider Business Mailing Address
First Line	:	2020 WESTCREEK LN APT 2312
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-3643
Country	:	US
Telephone Number	:	832-518-0579
Fax Number	:

Provider Business Practice Location Address
First Line	:	3830 WILCREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-6718
Country	:	US
Telephone Number	:	832-518-0579
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOSHUA OKONYE
Credential	:	PT, DPT, CSCS
Telephone Number	:	832-518-0579

Provider Enumeration Date	:	07/06/2024
Last Update Date	:	07/06/2024

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Directions to “SYNRG PERFORMANCE ” Practice Location

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