Provider Demographics
NPI:1831282631
Name:O'NEILL, DANIEL BENEDICT (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:BENEDICT
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16840 BUCCANEER LN STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2563
Mailing Address - Country:US
Mailing Address - Phone:281-333-5114
Mailing Address - Fax:832-284-4956
Practice Address - Street 1:16840 BUCCANEER LN STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2507
Practice Address - Country:US
Practice Address - Phone:281-333-5114
Practice Address - Fax:281-333-3674
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5441207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4312581OtherAETNA
TX88856YOtherBLUE CROSS/BLUE SHIELD
TXP000B75N6Medicaid
TX000B75NMedicare PIN
TXP000B75N6Medicaid