Healthcare Provider Details

I. General information

NPI: 1346331782
Provider Name (Legal Business Name): RENEE SNYDER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 04/03/2024
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 W 34TH ST STE 100
AUSTIN TX
78703-1432
US

IV. Provider business mailing address

1510 W 34TH ST STE 100
AUSTIN TX
78703-1432
US

V. Phone/Fax

Practice location:
  • Phone: 512-533-9900
  • Fax: 512-533-9901
Mailing address:
  • Phone: 512-533-9900
  • Fax: 512-533-9901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberM0280
License Number StateTX

VIII. Authorized Official

Name: RENEE R SNYDER
Title or Position: OWNER
Credential: MD
Phone: 512-533-9900