Provider Demographics
NPI:1265413959
Name:SNYDER, NED IV (MD)
Entity type:Individual
Prefix:
First Name:NED
Middle Name:
Last Name:SNYDER
Suffix:IV
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 1:1510 W 34TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-1432
Mailing Address - Country:US
Mailing Address - Phone:512-533-9900
Mailing Address - Fax:512-533-9901
Practice Address - Street 1:1510 W 34TH ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1432
Practice Address - Country:US
Practice Address - Phone:512-533-9900
Practice Address - Fax:512-533-9901
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM09272086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185231102Medicaid
TX185231102Medicaid
TXI39420Medicare UPIN