Provider Demographics
NPI:1144929449
Name:HARMON, SYNOLA
Entity type:Individual
Prefix:
First Name:SYNOLA
Middle Name:
Last Name:HARMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4377 COUNTY ROAD 4305
Mailing Address - Street 2:
Mailing Address - City:LARUE
Mailing Address - State:TX
Mailing Address - Zip Code:75770-2934
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4377 COUNTY ROAD 4305
Practice Address - Street 2:
Practice Address - City:LARUE
Practice Address - State:TX
Practice Address - Zip Code:75770-2934
Practice Address - Country:US
Practice Address - Phone:903-978-0275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2174218225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant