MEDICARE: OMNISYN, LLC

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	225100000X	Physical Therapist
2	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1295543650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNISYN, LLC

Provider Business Mailing Address
First Line	:	1606 HEADWAY CIR STE 9831
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78754-5123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1606 HEADWAY CIR STE 9831
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78754-5123
Country	:	US
Telephone Number	:	346-413-1887
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JULIA ELIZABETH COULON
Credential	:
Telephone Number	:	346-413-1887

Provider Enumeration Date	:	12/18/2024
Last Update Date	:	01/27/2025

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Directions to “OMNISYN, LLC ” Practice Location

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