Provider Demographics
NPI:1346642857
Name:SNOBER, BASHAR (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:BASHAR
Middle Name:
Last Name:SNOBER
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 DAVIS LN STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-4031
Mailing Address - Country:US
Mailing Address - Phone:512-960-4225
Mailing Address - Fax:
Practice Address - Street 1:5301 DAVIS LN STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-4031
Practice Address - Country:US
Practice Address - Phone:225-775-0160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXTX337841223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2868055Medicaid