Provider Demographics
NPI:1992816953
Name:JAMES PATRICK ONEAL MD PA
Entity type:Organization
Organization Name:JAMES PATRICK ONEAL MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED MEDICAL ASST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-582-5699
Mailing Address - Street 1:18059 HIGHWAY 105 W
Mailing Address - Street 2:STE 120
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356
Mailing Address - Country:US
Mailing Address - Phone:936-582-5699
Mailing Address - Fax:936-582-5698
Practice Address - Street 1:18059 HIGHWAY 105 W
Practice Address - Street 2:STE 120
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356
Practice Address - Country:US
Practice Address - Phone:936-582-5699
Practice Address - Fax:936-582-5698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1272207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175355001Medicaid
TX0069RGOtherBCBS
TX8AW741OtherBCBS
TX0069RGOtherBCBS
TX175355001Medicaid