Healthcare Provider Details
I. General information
NPI: 1588985246
Provider Name (Legal Business Name): SEAN O'NEIL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/17/2010
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
903 W MARTIN ST
SAN ANTONIO TX
78207-0903
US
IV. Provider business mailing address
7703 FLOYD CURL DR
SAN ANTONIO TX
78229-3901
US
V. Phone/Fax
- Phone: 210-358-3555
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | R3569 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | R3569 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: