Provider Demographics
NPI:1700813102
Name:O'NEIL, KEVIN PATRICK (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:PATRICK
Last Name:O'NEIL
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 1:3501 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3651
Mailing Address - Country:US
Mailing Address - Phone:972-256-3700
Mailing Address - Fax:866-630-6348
Practice Address - Street 1:3501 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3651
Practice Address - Country:US
Practice Address - Phone:972-256-3700
Practice Address - Fax:866-630-6348
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3812207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX047822404Medicaid
TX047822403Medicaid
TX8CU927OtherBCBS
TX047822404Medicaid
TX047822403Medicaid
TX8CU927OtherBCBS