Provider Demographics
NPI:1821112707
Name:SNEAD, JONATHAN C II (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:C
Last Name:SNEAD
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:10932 N RIVERSIDE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-7136
Mailing Address - Country:US
Mailing Address - Phone:817-741-9663
Mailing Address - Fax:817-741-3691
Practice Address - Street 1:10932 N RIVERSIDE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-7136
Practice Address - Country:US
Practice Address - Phone:817-741-9663
Practice Address - Fax:817-741-3691
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2016-12-15
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Provider Licenses
StateLicense IDTaxonomies
TXL6186207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1768475-01Medicaid
TX1768475-01Medicaid
TXI41394Medicare UPIN