Individual
MARY ONEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
13737 NOEL ROAD, STE 1400, DALLAS, TX 75240-2004
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650426, DALLAS, TX 75265-0426
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
425067
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
088948701
—
TX
05
—
088948704
—
TX
01
—
088948705
MEDICAID CSHCN
TX
01
—
430048342
RR MEDICARE
TX
01
—
81004U
BCBS
TX
Enumeration date
10/17/2006
Last updated
09/13/2013
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