Provider Demographics
NPI:1831501170
Name:SYNERGY SURGICAL ASSISTING
Entity Type:Organization
Organization Name:SYNERGY SURGICAL ASSISTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEWIS-BONIFAZI
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:832-654-9379
Mailing Address - Street 1:15011 BADGER RANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8829
Mailing Address - Country:US
Mailing Address - Phone:832-654-9379
Mailing Address - Fax:254-399-6493
Practice Address - Street 1:15011 BADGER RANCH BLVD
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-8829
Practice Address - Country:US
Practice Address - Phone:832-654-9379
Practice Address - Fax:254-399-6493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty