Healthcare Provider Details

I. General information

NPI: 1144808270
Provider Name (Legal Business Name): TAYLOR SNYDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 S HOUSTON AVE STE 400
TULSA OK
74127-9007
US

IV. Provider business mailing address

717 S HOUSTON AVE STE 400
TULSA OK
74127-9007
US

V. Phone/Fax

Practice location:
  • Phone: 918-382-4600
  • Fax:
Mailing address:
  • Phone: 918-382-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: