Provider Demographics
NPI:1487915195
Name:INSYNERGY
Entity type:Organization
Organization Name:INSYNERGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:TACA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-649-7867
Mailing Address - Street 1:11477 OLDE CABIN RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7129
Mailing Address - Country:US
Mailing Address - Phone:314-649-7867
Mailing Address - Fax:
Practice Address - Street 1:11477 OLDE CABIN RD STE 210
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7129
Practice Address - Country:US
Practice Address - Phone:314-649-7867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty