Provider Demographics
NPI:1790130839
Name:SYNERGOS SURGICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:SYNERGOS SURGICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ORAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-820-1900
Mailing Address - Street 1:PO BOX 9879
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77387-6879
Mailing Address - Country:US
Mailing Address - Phone:281-820-1900
Mailing Address - Fax:281-820-1901
Practice Address - Street 1:1803 LOWELL CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6100
Practice Address - Country:US
Practice Address - Phone:281-820-1900
Practice Address - Fax:281-820-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty