Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 99388 | TX |
NPI | 1104474915 |
---|---|
Provider Name | Tara Eileen O'neill |
First Address | Dickinson, TX 77539-5642 |
Second Address | Dickinson, TX 77539-5642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2019 |
Last Update Date | 27/08/2019 |