Healthcare Provider Details

I. General information

NPI: 1205193208
Provider Name (Legal Business Name): LAURA LYNN SNYDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 LAKE BOONE TRL STE 302
RALEIGH NC
27607
US

IV. Provider business mailing address

1512 W 35TH ST STE 200
AUSTIN TX
78703-1437
US

V. Phone/Fax

Practice location:
  • Phone: 919-782-8038
  • Fax: 919-782-8189
Mailing address:
  • Phone: 512-451-0103
  • Fax: 512-451-2741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number2017-02592
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberW1904
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2017-02592
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberW1904
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: