MEDICARE: DR. BILLY SNOW ED.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1083204028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BILLY SNOW ED.D

Provider Business Mailing Address
First Line	:	300 N AKARD ST APT 1323
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-3456
Country	:	US
Telephone Number	:	469-285-0949
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 N AKARD ST APT 1323
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-3456
Country	:	US
Telephone Number	:	469-285-0949
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2021
Last Update Date	:	01/23/2021

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Directions to “ DR. BILLY SNOW ED.D” Practice Location

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