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NPI Code Detail

MEDICARE: ZACHARY SCOTT O'NEAL PA-C

MEDICARE: ZACHARY SCOTT O'NEAL PA-C
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
1363A00000XPhysician AssistantPA05840TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1839N46OTHERTXBCBS
2TXB121160OTHERTXPTAN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801052949
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY SCOTT O'NEAL PA-C
Provider Business Mailing Address
First Line : PO BOX 22000
Second Line :
City : SAN ANGELO
State : TX
Zip : 76902-7200
Country : US
Telephone Number : 325-657-5028
Fax Number :
Provider Business Practice Location Address
First Line : 3502 KNICKERBOCKER RD
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-7671
Country : US
Telephone Number : 325-481-2222
Fax Number : 325-481-2232
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2008
Last Update Date : 10/12/2017

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Directions to “ ZACHARY SCOTT O'NEAL PA-C” Practice Location

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