Provider Demographics
NPI:1376527218
Name:O'NEAL, JAMES PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:508 MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2953
Mailing Address - Country:US
Mailing Address - Phone:936-523-1422
Mailing Address - Fax:936-523-1440
Practice Address - Street 1:508 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2953
Practice Address - Country:US
Practice Address - Phone:936-523-1422
Practice Address - Fax:936-523-1440
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1272207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CA306OtherBCBS-SADLER
TX094010801OtherMEDICAID GROUP-SADLER
TX1114979127OtherNPI GROUP-SADLER
TX741763675OtherTAX ID - SADLER
10035579OtherAMERIGROUP
207Y00000XOtherTAXONOMY
TX8L13622Medicare PIN