Basic Information
| Provider Information | |||||||||
| NPI: | 1356762710 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SNEDEGAR | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | JASON | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1430 COLLIER ST | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787042911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124724357 | ||||||||
| FaxNumber: | 5127031394 | ||||||||
| Practice Location | |||||||||
| Address1: | 8606 COLONIAL DR | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787587214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124835879 | ||||||||
| FaxNumber: | 5123547445 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2014 | ||||||||
| LastUpdateDate: | 01/24/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 831322 | TX | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 163W00000X | 831322 | TX | Y | Nursing Service Providers | Registered Nurse |
No ID Information.