Individual
MICHAEL S O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3615 19TH ST, LUBBOCK, TX 79410-1203
(806) 725-4479
Mailing address
3420 22ND PL, LUBBOCK, TX 79410-1314
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J0168
TX
208000000X
Pediatrics Physician
J0168
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000F9174
—
NM
05
—
136118009
—
TX
Enumeration date
10/26/2006
Last updated
03/16/2010
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