MEDICARE: MICHAEL EDWARD O'NEILL DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	15992	TX

General Provider Information

NPI Number	:	1790539955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL EDWARD O'NEILL DC

Provider Business Mailing Address
First Line	:	9608 BARTLETT CIR # 130
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76108-4449
Country	:	US
Telephone Number	:	817-367-7333
Fax Number	:	817-367-2007

Provider Business Practice Location Address
First Line	:	9608 BARTLETT CIR # 130
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76108-4449
Country	:	US
Telephone Number	:	817-367-7333
Fax Number	:	817-367-2007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2024
Last Update Date	:	04/15/2024

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