Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | H8420 | TX |
Y | 208600000X | Surgeon | H8420 | TX |
NPI | 1023067485 |
---|---|
Provider Name | Robert G Snow |
First Address | Fort Worth, TX 76102-5825 |
Second Address | Fort Worth, TX 76102-5825 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 20/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F33332 | (02) |