Provider Demographics
NPI:1346331782
Name:RENEE SNYDER MD PA
Entity Type:Organization
Organization Name:RENEE SNYDER MD PA
Other - Org Name:SNYDER DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-533-9900
Mailing Address - Street 1:1510 W 34TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-1432
Mailing Address - Country:US
Mailing Address - Phone:512-533-9900
Mailing Address - Fax:512-533-9901
Practice Address - Street 1:1510 W 34TH ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1432
Practice Address - Country:US
Practice Address - Phone:512-533-9900
Practice Address - Fax:512-533-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0280207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00430YOtherMEDICARE GROUP PTAN
TX00430YOtherMEDICARE GROUP PTAN