Healthcare Provider Details

I. General information

NPI: 1356212930
Provider Name (Legal Business Name): KENNETH SNYDER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2307 KOLBY WAY
HOUSTON TX
77073-6925
US

IV. Provider business mailing address

622 CENTRAL AVE # A255
JOHNSTOWN PA
15902-2701
US

V. Phone/Fax

Practice location:
  • Phone: 929-410-5754
  • Fax:
Mailing address:
  • Phone: 929-410-5754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KENNETH SNYDER
Title or Position: OWNER
Credential:
Phone: 929-410-5754