Provider Demographics
NPI:1861193419
Name:ONEAL, SAMANTHA KAY (APRN-BC)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:KAY
Last Name:ONEAL
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7317 CHANEL CT
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-8243
Mailing Address - Country:US
Mailing Address - Phone:703-899-4995
Mailing Address - Fax:
Practice Address - Street 1:4703 W LOVERS LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-3135
Practice Address - Country:US
Practice Address - Phone:214-352-8800
Practice Address - Fax:866-440-0439
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1111160363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty