Provider Demographics
NPI:1396133328
Name:SYNAPSES IOM LLC
Entity type:Organization
Organization Name:SYNAPSES IOM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-315-6432
Mailing Address - Street 1:43422 W OAKS DR STE 206
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-3300
Mailing Address - Country:US
Mailing Address - Phone:866-766-3783
Mailing Address - Fax:248-773-7703
Practice Address - Street 1:111 BOLAND ST STE 211
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-1265
Practice Address - Country:US
Practice Address - Phone:866-766-3783
Practice Address - Fax:248-773-7703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty