MEDICARE: DON M. O'NEAL, M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	E2769	TX

General Provider Information

NPI Number	:	1295016152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DON M. O'NEAL, M.D., P.A.

Provider Business Mailing Address
First Line	:	1402 MEDICAL DR
Second Line	:	SUITE B
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-2199
Country	:	US
Telephone Number	:	903-439-4408
Fax Number	:	903-885-7126

Provider Business Practice Location Address
First Line	:	1402 MEDICAL DR
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-2199
Country	:	US
Telephone Number	:	903-439-4408
Fax Number	:	903-885-7126

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DON MARTIN O'NEAL
Credential	:	M.D.
Telephone Number	:	903-439-4408

Provider Enumeration Date	:	09/06/2011
Last Update Date	:	04/22/2013

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