NPIMap

Organization Active NPI

Synergenx Health - Vintage Park LLC

  • Primary Care Clinic/Center
  • Houston, TX
National Provider Identifier
1649703844
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SYNERGENX HEALTH - VINTAGE PARK LLC
Practice address
130 Vintage Park Blvd
Building C, Suite H
Houston, TX 77070-3999
Phone
(281) 970-5900
Fax
(281) 970-5913
NPI assigned
Apr 5, 2017
Last updated
Nov 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Authorized official

Name
Welton Wayne Wilson
Title
Ceo
Phone
(281) 429-8522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

130 Vintage Park Blvd
Building C, Suite H
Houston, TX 77070-3999

Mailing address

16131 N Eldridge Pkwy Ste 100
Tomball, TX 77377-9130
Phone (281) 429-8522

National Provider Directory

National Provider Directory

Locations

130 Vintage Park Blvd
Ste H
Houston, TX 77070
Phone (832) 899-5621

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1649703844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16131 N ELDRIDGE PKWY STE 100",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773779130",
            "telephone_number": "281-429-8522",
            "fax_number": "281-970-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 VINTAGE PARK BLVD",
            "address_2": "BUILDING C, SUITE H",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770703999",
            "telephone_number": "281-970-5900",
            "fax_number": "281-970-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGENX HEALTH - VINTAGE PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-11-02",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WELTON",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-429-8522"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.