Provider Demographics
NPI:1043434186
Name:SYZYGY ASSOC. L.P.
Entity Type:Organization
Organization Name:SYZYGY ASSOC. L.P.
Other - Org Name:SOURCE ONE REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JARROD
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-370-0404
Mailing Address - Street 1:12200 PARK CENTRAL DR STE 210
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2116
Mailing Address - Country:US
Mailing Address - Phone:972-239-7246
Mailing Address - Fax:214-948-1174
Practice Address - Street 1:12200 PARK CENTRAL DR STE 210
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2116
Practice Address - Country:US
Practice Address - Phone:972-239-7246
Practice Address - Fax:214-948-1174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111742225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty