MEDICARE: DR. JAMES PATRICK O'NEAL MD

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	207Y00000X	Otolaryngology Physician	M1272	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8CA306	OTHER	TX	BCBS-SADLER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1114979127	OTHER	TX	NPI GROUP-SADLER
4	741763675	OTHER	TX	TAX ID - SADLER
5	10035579	OTHER		AMERIGROUP
6	207Y00000X	OTHER		TAXONOMY

General Provider Information

NPI Number	:	1376527218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES PATRICK O'NEAL MD

Provider Business Mailing Address
First Line	:	508 MEDICAL CENTER BLVD
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-2953
Country	:	US
Telephone Number	:	936-523-1422
Fax Number	:	936-523-1440

Provider Business Practice Location Address
First Line	:	508 MEDICAL CENTER BLVD
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-2953
Country	:	US
Telephone Number	:	936-523-1422
Fax Number	:	936-523-1440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	02/08/2022

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