MEDICARE: DR. BASHAR SNOBER DDS, MSD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	1223P0700X	Prosthodontics	TX33784	TX

General Provider Information

NPI Number	:	1346642857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BASHAR SNOBER DDS, MSD

Provider Business Mailing Address
First Line	:	5301 DAVIS LN STE 101
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-4031
Country	:	US
Telephone Number	:	512-960-4225
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 DAVIS LN STE 101
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-4031
Country	:	US
Telephone Number	:	225-775-0160
Fax Number	:

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

Provider Enumeration Date	:	09/16/2014
Last Update Date	:	10/03/2022

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