MEDICARE: SYNERGY INTERNATIONAL HEALTHCARE SERVICES, INC.

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	261QM1300X	Multi-Specialty Clinic/Center
2	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598475246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGY INTERNATIONAL HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	5400 E TEXAS ST
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-6906
Country	:	US
Telephone Number	:	318-675-1313
Fax Number	:	318-675-1319

Provider Business Practice Location Address
First Line	:	5400 E TEXAS ST
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-6906
Country	:	US
Telephone Number	:	318-675-1313
Fax Number	:	318-675-1319

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CINDER IRENE PUCKETT
Credential	:
Telephone Number	:	318-464-7504

Provider Enumeration Date	:	12/02/2022
Last Update Date	:	02/26/2024

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