=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245067602
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET O'NEAL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2024
-----------------------------------------------------
Last Update Date | 05/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 416 FRANKFORD AVE
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79416-4162
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-743-2424
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4705 BRIARWOOD AVENUE
-----------------------------------------------------
City | MIDLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79707-2639
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 432-505-4145
-----------------------------------------------------
Fax | 833-941-0864
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1175477
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------