MEDICARE: KATHRYN SNEED

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	172V00000X	Community Health Worker	12492	TX

General Provider Information

NPI Number	:	1093542615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN SNEED

Provider Business Mailing Address
First Line	:	5141 DAZZLE DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75232-1913
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5141 DAZZLE DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75232-1913
Country	:	US
Telephone Number	:	214-725-1968
Fax Number	:

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

Provider Enumeration Date	:	09/17/2024
Last Update Date	:	09/17/2024

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Directions to “ KATHRYN SNEED ” Practice Location

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