Provider Demographics
NPI:1518283688
Name:SNYDER, GRACE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:MARIE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:MARIE
Other - Last Name:SNYDER-GARZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2325 E SAUNDERS ST
Mailing Address - Street 2:PLAZA TWO
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5434
Mailing Address - Country:US
Mailing Address - Phone:956-723-4673
Mailing Address - Fax:956-723-3133
Practice Address - Street 1:2325 E SAUNDERS ST
Practice Address - Street 2:PLAZA TWO
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5434
Practice Address - Country:US
Practice Address - Phone:956-723-4673
Practice Address - Fax:956-723-3133
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7745207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1518283688Medicaid
TX359084603Medicaid