Basic Information
| Provider Information | |||||||||
| NPI: | 1386606606 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SNYDER | ||||||||
| FirstName: | SAMUEL | ||||||||
| MiddleName: | K. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2646 | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785022646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563625650 | ||||||||
| FaxNumber: | 9563622574 | ||||||||
| Practice Location | |||||||||
| Address1: | 2609 MICHAELANGELO DR | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785391417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563625650 | ||||||||
| FaxNumber: | 9563622574 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2006 | ||||||||
| LastUpdateDate: | 12/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | F7926 | TX | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 116537504 | 05 | TX | MEDICAID | H085569Q01 | 01 | TX | BCBS | OTHER |