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General NPI Number Information
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NPI Number | 1598054009
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Entity Type | Organization
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Legal Business Name | ANTHONY J O'CONNELL, M.D., P.A.
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 12222 N CENTRAL EXPY SUITE 240
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City | DALLAS
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State | TX
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Zip | 75243-3720
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Country | US
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Telephone | 972-235-8088
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Fax | 972-235-8090
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Provider Business Mailing Address
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Address Line | PO BOX 451388
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City | GARLAND
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State | TX
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Zip | 75045-1388
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Country | US
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Telephone | 972-235-8088
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Fax | 972-235-8090
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY J. O'CONNELL
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Credential | M.D.
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Telephone | 972-235-8088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K5169
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License Number State | TX
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