Synergy Aesthetics & Wellness

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

K9742 Issued in NU

Legal business name

SYNERGY AESTHETICS & WELLNESS

Practice address

12501 Canyon Falls Blvd
Suite B
Willis, TX 77318-5825

Phone

(936) 449-8008

Fax

(936) 449-8007

NPI assigned

Apr 7, 2016

Last updated

Apr 7, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeffrey Pruski

Title

President

Phone

(936) 661-2584

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459987200000",
    "number": "1396109138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 CANYON FALLS BLVD",
            "address_2": "SUITE B",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773185825",
            "telephone_number": "936-449-8008",
            "fax_number": "936-449-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 CANYON FALLS BLVD",
            "address_2": "SUITE B",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773185825",
            "telephone_number": "936-449-8008",
            "fax_number": "936-449-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY AESTHETICS & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-04-07",
        "status": "A",
        "authorized_official_last_name": "PRUSKI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-661-2584",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": "K9742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn Loretta Stone, LVN
• Levi Ross Stone, MSN, APRN, FNP-C
• Nancy Storie, RN
• Tanita Shanta Sullivan
• Stacey Jo Swatzel, BCBA, LBA
• Wendy Marie Szymanski, OPA-C
• Kehmia Tangeh
• Lara Taylor, BCBA
• Texas New Community Alliance (New Danville)
• Thomas G. Lee, D.D.S., Inc.

• General Practice Physician in Willis, TX
• Providers in Willis, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.