Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | K3812 | TX |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | K3812 | TX |
NPI | 1700813102 |
---|---|
Provider Name | Kevin Patrick O'neil |
First Address | Irving, TX 75062-3651 |
Second Address | Irving, TX 75062-3651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 14/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
047822403 | (05) | TX |
047822404 | (05) | TX |
8CU927 | BCBS (01) | TX |
G50744 | (02) | TX |