Provider Demographics
NPI:1780794446
Name:O'NEILL, ERIC F (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:F
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 1:1000 W. HIGHWAY 6
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7922
Mailing Address - Country:US
Mailing Address - Phone:254-741-6832
Mailing Address - Fax:254-741-0821
Practice Address - Street 1:1000 W. HIGHWAY 6
Practice Address - Street 2:SUITE 500
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7922
Practice Address - Country:US
Practice Address - Phone:254-741-6832
Practice Address - Fax:254-741-0821
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2650208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
00T66DMedicare ID - Type Unspecified
F56185Medicare UPIN