Provider Demographics
NPI:1942260898
Name:SNYDER, EDWARD H (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:H
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:PO BOX 3926
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76902-3926
Mailing Address - Country:US
Mailing Address - Phone:325-658-3576
Mailing Address - Fax:325-658-7737
Practice Address - Street 1:3308 FOSTER ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-9314
Practice Address - Country:US
Practice Address - Phone:325-658-3576
Practice Address - Fax:325-658-7737
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF00082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1326217Medicaid
TX110781OtherCHIP-SUPERIOR HEALTH
TX110781OtherCHIP-SUPERIOR HEALTH
TX1326217Medicaid