1548321532 NPI number — REBECCA LYNN SNAPP CRNA

Table of content: AKIA DANIELLE DAVIS (NPI 1548851272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548321532 NPI number — REBECCA LYNN SNAPP CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SNAPP
Provider First Name:
REBECCA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SNAPP
Provider Other First Name:
BECKY
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1548321532
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3612 POTEET DR
Provider Second Line Business Mailing Address:
APT 512
Provider Business Mailing Address City Name:
MESQUITE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75150-7642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-276-6100
Provider Business Mailing Address Fax Number:
972-276-1231

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 WALTER REED BLVD
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
GARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75042-3701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-276-6100
Provider Business Practice Location Address Fax Number:
972-276-1231
Provider Enumeration Date:
12/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  234044 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 159462401 . This is a "TX MEDICAID GROUP NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 470862522 . This is a "TAX ID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 160543802 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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