Provider Demographics
NPI:1235193152
Name:SNELLING, JON BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:BENJAMIN
Last Name:SNELLING
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3301 S ALAMEDA ST
Mailing Address - Street 2:SUITE #403
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1882
Mailing Address - Country:US
Mailing Address - Phone:361-853-7319
Mailing Address - Fax:361-853-1641
Practice Address - Street 1:3301 S ALAMEDA ST
Practice Address - Street 2:SUITE #403
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1882
Practice Address - Country:US
Practice Address - Phone:361-853-7319
Practice Address - Fax:361-853-1641
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2009-01-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE8179207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX887922OtherBC/BS TX#
TX119169403Medicaid
TX180015985OtherRAILROAD GBA - RAILROAD MEDICARE
TX079603901Medicaid
TX8BB570OtherBCBS OF TEXAS
TX8L0628Medicare PIN
TX119169403Medicaid
TX8BB570OtherBCBS OF TEXAS