Provider Demographics
NPI:1962687285
Name:SYNERGY NUTRITION
Entity Type:Organization
Organization Name:SYNERGY NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERD DIETITIAN / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:956-631-6861
Mailing Address - Street 1:809 S 41ST ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:809 S 41ST ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8402
Practice Address - Country:US
Practice Address - Phone:956-631-6861
Practice Address - Fax:956-631-6861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-05
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty