Provider Demographics
NPI:1952324162
Name:ONEAL, ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:ONEAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 N 23RD ST
Mailing Address - Street 2:STE 201
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-2241
Mailing Address - Country:US
Mailing Address - Phone:409-839-4600
Mailing Address - Fax:409-833-0086
Practice Address - Street 1:324 N 23RD ST
Practice Address - Street 2:STE 201
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-2241
Practice Address - Country:US
Practice Address - Phone:409-839-4600
Practice Address - Fax:409-833-0086
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081498002Medicaid
TXT15114Medicare UPIN
TX081498002Medicaid