Provider Demographics
NPI:1417103524
Name:SYNERGY MEDICAL EQUIPMENT AND SUPPLIES
Entity Type:Organization
Organization Name:SYNERGY MEDICAL EQUIPMENT AND SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:IDALIA
Authorized Official - Last Name:ARREOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-627-3721
Mailing Address - Street 1:2723 CORNERSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8464
Mailing Address - Country:US
Mailing Address - Phone:956-627-3721
Mailing Address - Fax:956-627-3722
Practice Address - Street 1:2723 CORNERSTONE BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8464
Practice Address - Country:US
Practice Address - Phone:956-627-3721
Practice Address - Fax:956-627-3722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-09
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0105178332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200246102Medicaid
TX200246103Medicaid
TX200246101Medicaid
TX6158250001Medicare NSC