Basic Information
Provider Information
NPI: 1225391543
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SNITZER
FirstName: LAUREN
MiddleName: ALLYSON
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5310 HARVEST HILL RD STE 290
Address2:  
City: DALLAS
State: TX
PostalCode: 752305826
CountryCode: US
TelephoneNumber: 2144200650
FaxNumber: 2147360512
Practice Location
Address1: 1327 LAKE POINTE PKWY STE 416
Address2:  
City: SUGAR LAND
State: TX
PostalCode: 774783499
CountryCode: US
TelephoneNumber: 2814940050
FaxNumber: 2814940075
Other Information
ProviderEnumerationDate: 06/21/2012
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000X2012018188MON Allopathic & Osteopathic PhysiciansDermatology 
207N00000XR2017TXY Allopathic & Osteopathic PhysiciansDermatology 

No ID Information.


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