Individual provider Active NPI

Theodore Snider, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Shavano Park, TX
National Provider Identifier
1194707950
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
H8418 Issued in TX
Practice address
4085 De Zavala Rd
Suite 200
Shavano Park, TX 78249-2084
Phone
(210) 558-6288
Fax
(210) 558-6289
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X H8418 TX Primary

Addresses

Primary practice location

4085 De Zavala Rd
Suite 200
Shavano Park, TX 78249-2084

Mailing address

PO Box 681149
San Antonio, TX 78268-1149
Phone (210) 558-6288

Other identifiers 1

IdentifierTypeStateIssuer
103547905MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070306000503 TX Practitioner - Pathology 7214939008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Medical School at Houston, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Pathology Associates LLPGroup PAC ID 6406851054, 25 clinicians

Practice addresses (Care Compare)

1139 E Sonterra Blvd
Pathology Department
San Antonio, TX 78258-3999
Phone (210) 558-6288

4085 De Zavala Rd
Shavano Park, TX 78249-2084
Phone (210) 558-6288

7700 Floyd Curl Dr
San Antonio, TX 78229-3902
Phone (210) 558-6288

8026 Floyd Curl Dr
San Antonio, TX 78229-3915
Phone (210) 558-6288

Hospital & facility affiliations

  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388
  • Methodist Hospital Stone Oak Hospital, San Antonio, TX, CCN 670055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H8418TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Pathology Associates LLP Anatomic Pathology & Clinical Pathology CurrentSince Jul 15, 2007 Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology Past Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

4085 De Zavala Rd
Shavano Park, TX 78249

4085 De Zavala Rd
Ste 200
Shavano Park, TX 78249
Phone 2105586288123

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1194707950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681149",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782681149",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 DE ZAVALA RD",
            "address_2": "SUITE 200",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782492084",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIDER",
        "first_name": "THEODORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "H8418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103547905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shavano Park, TX

Sources for this page

Verify at the official NPI Registry.