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General NPI Number Information
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NPI Number | 1124654587
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Entity Type | Individual
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Provider Name | JAMES KELLY ONEIL RPH
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Gender | Male
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Dates
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Enumeration Date | 03/18/2020
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 1615 GRAND AVENUE PKWY
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-2059
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Country | US
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Telephone | 512-377-1999
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Fax | 512-252-2662
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Provider Business Mailing Address
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Address Line | 1101 DEBUS DR
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City | TAYLOR
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State | TX
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Zip | 76574-2116
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Country | US
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Telephone | 512-940-9009
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 20109
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License Number State | TX
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