Provider Demographics
NPI:1083725816
Name:SNOKHOUS, PAULA ANN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ANN
Last Name:SNOKHOUS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 W OAK ST
Mailing Address - Street 2:PO BOX 458
Mailing Address - City:WEST
Mailing Address - State:TX
Mailing Address - Zip Code:76691
Mailing Address - Country:US
Mailing Address - Phone:254-826-3865
Mailing Address - Fax:254-826-7071
Practice Address - Street 1:407 W OAK ST
Practice Address - Street 2:
Practice Address - City:WEST
Practice Address - State:TX
Practice Address - Zip Code:76691
Practice Address - Country:US
Practice Address - Phone:254-826-3865
Practice Address - Fax:254-826-7071
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02665363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00701NMedicare PIN