Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 1544 | NE |
NPI | 1033503990 |
---|---|
Provider Name | Eldon Snyder |
First Address | Fort Sam Houston, TX 78234-4501 |
Second Address | Fort Sam Houston, TX 78234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2015 |
Last Update Date | 10/12/2018 |