Provider Demographics
NPI:1245989094
Name:SNYDER, EUGENE ROBERT JR (PCA II)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:ROBERT
Last Name:SNYDER
Suffix:JR
Gender:M
Credentials:PCA II
Other - Prefix:MR
Other - First Name:EUGENE
Other - Middle Name:ROBERT
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PCA II
Mailing Address - Street 1:602 SW 38TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6912
Mailing Address - Country:US
Mailing Address - Phone:580-248-5780
Mailing Address - Fax:
Practice Address - Street 1:602 SW 38TH ST
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6912
Practice Address - Country:US
Practice Address - Phone:580-248-5780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist