Provider Demographics
NPI:1164483509
Name:SNELL-HARGROVE, DANA N (DO)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:N
Last Name:SNELL-HARGROVE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 54126
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-4126
Mailing Address - Country:US
Mailing Address - Phone:817-537-5000
Mailing Address - Fax:817-537-5005
Practice Address - Street 1:4109 CITY POINT DR
Practice Address - Street 2:SUITE F
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8339
Practice Address - Country:US
Practice Address - Phone:817-537-5000
Practice Address - Fax:817-537-5005
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8511207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10014219OtherAMERIGROUP
TX8C6621OtherMEDICARE
TX167492101Medicaid
TX167492103Medicaid
TX167492103Medicaid
I18710Medicare UPIN