Provider Demographics
NPI:1952689739
Name:O'NEAL, BRENDAN TIGHE
Entity Type:Individual
Prefix:MR
First Name:BRENDAN
Middle Name:TIGHE
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 GALENA PINES RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-9760
Mailing Address - Country:US
Mailing Address - Phone:775-830-2073
Mailing Address - Fax:
Practice Address - Street 1:305 GALENA PINES RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-9760
Practice Address - Country:US
Practice Address - Phone:775-830-2073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker