Provider Demographics
NPI:1750627618
Name:SYNERGY HOMECARE OF LUBBOCK
Entity type:Organization
Organization Name:SYNERGY HOMECARE OF LUBBOCK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-438-0089
Mailing Address - Street 1:7202 JOLIET AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1112
Mailing Address - Country:US
Mailing Address - Phone:806-589-0400
Mailing Address - Fax:888-606-1222
Practice Address - Street 1:7202 JOLIET AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1112
Practice Address - Country:US
Practice Address - Phone:806-589-0400
Practice Address - Fax:888-606-1222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014547253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care