Provider Demographics
| NPI: | 1831871185 |
|---|---|
| Name: | SYNERGY PRIMECARE PLLC |
| Entity type: | Organization |
| Organization Name: | SYNERGY PRIMECARE PLLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT/OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | SHIRLEY |
| Authorized Official - Middle Name: | ADAEZE |
| Authorized Official - Last Name: | AMANFO |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | APRN, FNP-C, MSN |
| Authorized Official - Phone: | 281-752-6233 |
| Mailing Address - Street 1: | 406 SUMMERSET LANE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BROOKSHIRE |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77423 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 281-752-6233 |
| Mailing Address - Fax: | 866-635-1388 |
| Practice Address - Street 1: | 1331 N GRAND PKWY STE 111 |
| Practice Address - Street 2: | |
| Practice Address - City: | KATY |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77493-2711 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 301-717-9249 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-08-07 |
| Last Update Date: | 2024-06-28 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | Group - Single Specialty |