Provider Demographics
NPI:1770769440
Name:SNELL, MARGIE ARLENE (PTA)
Entity type:Individual
Prefix:
First Name:MARGIE
Middle Name:ARLENE
Last Name:SNELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6613 S FM 14
Mailing Address - Street 2:PO BOX 812
Mailing Address - City:HAWKINS
Mailing Address - State:TX
Mailing Address - Zip Code:75765-4832
Mailing Address - Country:US
Mailing Address - Phone:972-977-0623
Mailing Address - Fax:
Practice Address - Street 1:2201 HORSESHOE LN
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5650
Practice Address - Country:US
Practice Address - Phone:903-234-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-12
Last Update Date:2008-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2034213225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant