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General NPI Number Information
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NPI Number | 1720974470
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Entity Type | Organization
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Legal Business Name | ONEAL DIRECT HEALTH
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 818 MONTROSE DR STE B
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City | SHREVEPORT
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State | LA
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Zip | 71106-2012
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Country | US
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Telephone | 337-302-5453
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Fax | 337-302-5453
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Provider Business Mailing Address
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Address Line | 8702 GLEN HAVEN DR
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City | SHREVEPORT
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State | LA
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Zip | 71106-6222
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Country | US
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Telephone | 337-302-5453
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Fax | 318-725-3505
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER O'NEAL
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Credential | MD
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Telephone | 337-302-5453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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