MEDICARE: CHRISTINE N O'NEAL 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	363AM0700X	Medical Physician Assistant	PA04928	TX

General Provider Information

NPI Number	:	1518978386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE N O'NEAL P.A.

Provider Business Mailing Address
First Line	:	PO BOX 910
Second Line	:
City	:	JOSHUA
State	:	TX
Zip	:	76058-0910
Country	:	US
Telephone Number	:	817-558-4535
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 N BROADWAY ST
Second Line	:
City	:	JOSHUA
State	:	TX
Zip	:	76058-3066
Country	:	US
Telephone Number	:	817-558-4535
Fax Number	:

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	07/08/2007

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