MEDICARE: JAMES SNELL

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	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1912318080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES SNELL

Provider Business Mailing Address
First Line	:	PO BOX 592442
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78259-0172
Country	:	US
Telephone Number	:	210-598-2801
Fax Number	:	210-598-7268

Provider Business Practice Location Address
First Line	:	3502 PAESANOS PKWY STE 100
Second Line	:
City	:	SHAVANO PARK
State	:	TX
Zip	:	78231-1225
Country	:	US
Telephone Number	:	210-598-2801
Fax Number	:	210-598-7268

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

Provider Enumeration Date	:	05/12/2014
Last Update Date	:	05/12/2014

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Directions to “ JAMES SNELL ” Practice Location

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