Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | J7679 | TX |
Y | 207PE0004X | Emergency Medical Services | J7679 | TX |
NPI | 1003858119 |
---|---|
Provider Name | Kimberly Snyder |
First Address | Austin, TX 78746-7647 |
Second Address | Austin, TX 78758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 14/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043548901 | (05) | TX |
043548902 | (05) | TX |
F55244 | (02) | TX |