Provider Demographics
NPI:1902034630
Name:SNYDER, BRANDEN ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:BRANDEN
Middle Name:ANDREW
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 COTTONWOOD LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6117
Mailing Address - Country:US
Mailing Address - Phone:972-607-2525
Mailing Address - Fax:
Practice Address - Street 1:1110 COTTONWOOD LN
Practice Address - Street 2:SUITE 105
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6117
Practice Address - Country:US
Practice Address - Phone:972-607-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA264598207R00000X
TXQ9044207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX523462YKP5Medicare PIN