Provider Demographics
NPI:1760573893
Name:SNYDER, CHERYL A (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 PLAZA RD
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4242
Mailing Address - Country:US
Mailing Address - Phone:972-224-9000
Mailing Address - Fax:972-224-4242
Practice Address - Street 1:1300 PLAZA RD
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4242
Practice Address - Country:US
Practice Address - Phone:972-224-9000
Practice Address - Fax:972-224-4242
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6619207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033926901Medicaid
TX00HU51Medicare PIN
TX033926901Medicaid