Provider Demographics
NPI:1528393071
Name:SNOOK, ERIK (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:SNOOK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 SAFFRON WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-2304
Mailing Address - Country:US
Mailing Address - Phone:210-912-4063
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF THE ARMY
Practice Address - Street 2:15244
Practice Address - City:SOEUL
Practice Address - State:YOUNGSUN
Practice Address - Zip Code:APO AP 96205
Practice Address - Country:KR
Practice Address - Phone:8227-917-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1091017363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant