Provider Demographics
NPI:1710652789
Name:SYNAPSE ANESTHESIA SERVICES PLLC
Entity Type:Organization
Organization Name:SYNAPSE ANESTHESIA SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:817-479-6158
Mailing Address - Street 1:781 LONESOME DOVE TRL STE A
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-6018
Mailing Address - Country:US
Mailing Address - Phone:817-479-7280
Mailing Address - Fax:817-479-8283
Practice Address - Street 1:781 LONESOME DOVE TRL STE A
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-6018
Practice Address - Country:US
Practice Address - Phone:817-479-7280
Practice Address - Fax:817-479-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1234OtherANESTHESIA