Provider Demographics
NPI:1669010773
Name:SNYDER, AUDREY C (PA-C)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:C
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:C
Other - Last Name:SCHMITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1615 HOSPITAL PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-5936
Mailing Address - Country:US
Mailing Address - Phone:817-835-9379
Mailing Address - Fax:817-355-4515
Practice Address - Street 1:1615 HOSPITAL PKWY STE 210
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-5936
Practice Address - Country:US
Practice Address - Phone:817-835-9379
Practice Address - Fax:817-355-4515
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13244363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant