Provider Demographics
NPI:1982817318
Name:SYNERTX REHABILITATION
Entity Type:Organization
Organization Name:SYNERTX REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:888-873-4221
Mailing Address - Street 1:230 PR 3563
Mailing Address - Street 2:
Mailing Address - City:BALLINGER
Mailing Address - State:TX
Mailing Address - Zip Code:76821
Mailing Address - Country:US
Mailing Address - Phone:325-977-1064
Mailing Address - Fax:
Practice Address - Street 1:230 PR 3563
Practice Address - Street 2:
Practice Address - City:BALLINGER
Practice Address - State:TX
Practice Address - Zip Code:76821
Practice Address - Country:US
Practice Address - Phone:325-977-1064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108152261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation