Basic Information
| Provider Information | |||||||||
| NPI: | 1578083572 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SYNAPTIXS IONM, LLC | ||||||||
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| OtherOrganizationName: | OVERWATCH NEURO | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2586 | ||||||||
| Address2: | |||||||||
| City: | MCKINNEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750708172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037044621 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 N CENTRAL EXPY UNIT 2586 | ||||||||
| Address2: | |||||||||
| City: | MCKINNEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750700139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037044621 | ||||||||
| FaxNumber: | 6093535213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | SHINN | ||||||||
| AuthorizedOfficialFirstName: | DOREEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP FINANCE & BILLING | ||||||||
| AuthorizedOfficialTelephone: | 3037044621 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Electrodiagnostic Medicine | 246ZE0600X | N | 193200000X MULTI-SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Electroneurodiagnostic | 293D00000X | Y | Laboratories | Physiological Laboratory |
No ID Information.