Provider Demographics
NPI:1063411940
Name:SNYDER, GERALD (MD)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 633
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:HAMILTON
Mailing Address - State:TX
Mailing Address - Zip Code:76531-0633
Mailing Address - Country:US
Mailing Address - Phone:254-223-0950
Mailing Address - Fax:
Practice Address - Street 1:730 N HOUSTON AVE
Practice Address - Street 2:STE C
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4132
Practice Address - Country:US
Practice Address - Phone:830-620-4540
Practice Address - Fax:830-620-4991
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4571207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100607402Medicaid
TX341712YMJMMedicare PIN
TX100607402Medicaid