Provider Demographics
NPI:1417941113
Name:JEFFREY S. SNYDER, O.D & ASSOCIATES, PC
Entity Type:Organization
Organization Name:JEFFREY S. SNYDER, O.D & ASSOCIATES, PC
Other - Org Name:MOBILE EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-961-0940
Mailing Address - Street 1:4635 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 155
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7120
Mailing Address - Country:US
Mailing Address - Phone:713-961-0940
Mailing Address - Fax:713-961-1996
Practice Address - Street 1:4635 SOUTHWEST FWY
Practice Address - Street 2:SUITE 155
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7169
Practice Address - Country:US
Practice Address - Phone:713-961-0940
Practice Address - Fax:713-961-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-08
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019428402Medicaid
TX140706601Medicaid
4053500001Medicare NSC
83379EMedicare ID - Type UnspecifiedPERFORMING PROVIDER
00062SMedicare ID - Type Unspecified
TX019428402Medicaid
410044357Medicare ID - Type UnspecifiedRAILROAD MEDICARE