Provider Demographics
NPI:1366465874
Name:O'NEAL, MONTE CLINT (DO)
Entity Type:Individual
Prefix:
First Name:MONTE
Middle Name:CLINT
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 BEACHROCK DR
Mailing Address - Street 2:
Mailing Address - City:BROOKELAND
Mailing Address - State:TX
Mailing Address - Zip Code:75931-5628
Mailing Address - Country:US
Mailing Address - Phone:409-429-0315
Mailing Address - Fax:
Practice Address - Street 1:1565 BEACHROCK DR
Practice Address - Street 2:
Practice Address - City:BROOKELAND
Practice Address - State:TX
Practice Address - Zip Code:75931-5628
Practice Address - Country:US
Practice Address - Phone:409-429-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1334207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136381401Medicaid
TX136381401Medicaid
TX8K4210Medicare PIN
TXD49825Medicare UPIN