Provider Demographics
NPI:1366472250
Name:O'NEILL & ASSOCIATES P.A.
Entity Type:Organization
Organization Name:O'NEILL & ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:SAM
Authorized Official - Last Name:BELASCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-223-5543
Mailing Address - Street 1:1303 MCCULLOUGH AVE
Mailing Address - Street 2:125
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5609
Mailing Address - Country:US
Mailing Address - Phone:210-223-5543
Mailing Address - Fax:210-223-6830
Practice Address - Street 1:1303 MCCULLOUGH AVE
Practice Address - Street 2:125
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5609
Practice Address - Country:US
Practice Address - Phone:210-223-5543
Practice Address - Fax:210-223-6830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR06817174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094025601Medicaid
TX00A09JMedicare PIN