Provider Demographics
NPI:1861856114
Name:SYMEDIC PLLC
Entity Type:Organization
Organization Name:SYMEDIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLUMUYIWA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-566-2641
Mailing Address - Street 1:2245 TEXAS DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1679
Mailing Address - Country:US
Mailing Address - Phone:281-566-2641
Mailing Address - Fax:844-308-1082
Practice Address - Street 1:2245 TEXAS DR
Practice Address - Street 2:SUITE 300
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1679
Practice Address - Country:US
Practice Address - Phone:281-566-2641
Practice Address - Fax:844-308-1082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP19542084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP1954OtherTEXAS