Synergy Alliance LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SYNERGY ALLIANCE LLC

Practice address

315 E Wall St
Grapevine, TX 76051-5402

Phone

(972) 283-7277

Fax

(682) 323-5966

NPI assigned

Jul 31, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Willie Earl Walls III

Title

Ceo/President

Phone

(972) 897-0017

Specialties & licenses 1

Addresses

Other names 1

• My Royal Palace Doing business as

Locations

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1740411271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E WALL ST",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515402",
            "telephone_number": "972-283-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E WALL ST",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515402",
            "telephone_number": "972-283-7277",
            "fax_number": "682-323-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY ALLIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-31",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "972-897-0017",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Royal Palace",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "My Royal Palace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beverly Sweatt, M.S., CCC-SLP
• Catherine A Swiatocha, LPC
• Smitha Syamala Komatreddy
• Faez Syed, MD EXPECTED MAY 2020
• Uzma A Syeda, MD
• Synergy Home Healthcare, LLC
• Synergy Wellness & Chiropractic, PLLC
• Jessica Lauren Szymanski, LMT, MTI
• Tina Tallarico-Cutter, MS CCC/SLP
• Mary Yuh Tang, M.D.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.