Provider Demographics
NPI:1790289221
Name:SNELL, JOHNAE DESHAWN (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JOHNAE
Middle Name:DESHAWN
Last Name:SNELL
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:JOHNAE
Other - Middle Name:DESHAWN
Other - Last Name:OAKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6621 FANNIN ST STE A5590
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2358
Mailing Address - Country:US
Mailing Address - Phone:832-826-1549
Mailing Address - Fax:832-825-2799
Practice Address - Street 1:6621 FANNIN ST STE A5590
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2358
Practice Address - Country:US
Practice Address - Phone:832-826-1549
Practice Address - Fax:832-825-2799
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT25032080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program