MEDICARE: SYNERGIZE WELLNESS AND HEALTHCARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1922429018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGIZE WELLNESS AND HEALTHCARE INC

Provider Business Mailing Address
First Line	:	4040 AVONDALE AVE
Second Line	:	SUITE 303
City	:	DALLAS
State	:	TX
Zip	:	75219-3050
Country	:	US
Telephone Number	:	832-429-7781
Fax Number	:

Provider Business Practice Location Address
First Line	:	4040 AVONDALE AVE
Second Line	:	SUITE 303
City	:	DALLAS
State	:	TX
Zip	:	75219-3050
Country	:	US
Telephone Number	:	832-429-7781
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	BARRY GOGGANS
Credential	:
Telephone Number	:	832-429-7781

Provider Enumeration Date	:	12/17/2013
Last Update Date	:	12/17/2013

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