Provider Demographics
NPI:1124654587
Name:ONEIL, JAMES KELLY (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:KELLY
Last Name:ONEIL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:KELLY
Other - Last Name:O'NEIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:1101 DEBUS DR
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-2116
Mailing Address - Country:US
Mailing Address - Phone:512-940-9009
Mailing Address - Fax:
Practice Address - Street 1:1615 GRAND AVENUE PKWY
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2059
Practice Address - Country:US
Practice Address - Phone:512-377-1999
Practice Address - Fax:512-252-2662
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201091835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care