Healthcare Provider Details

I. General information

NPI: 1780673665
Provider Name (Legal Business Name): CHRISTOPHER S. SNEAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 01/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 MARVEL ST
COUSHATTA LA
71019-9022
US

IV. Provider business mailing address

919 HIDDEN RDG
IRVING TX
75038-3813
US

V. Phone/Fax

Practice location:
  • Phone: 318-932-2222
  • Fax: 318-932-2186
Mailing address:
  • Phone: 469-282-2711
  • Fax: 469-282-0996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25687
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: