| Tammy O'neal, Llc | |
|
3131 Executive Dr San Angelo TX 76904-6801 | |
| (325) 763-9906 | |
| Not Available |
| Full Name | Tammy O'neal, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3131 Executive Dr, San Angelo, Texas |
| Authorized Official Name and Position | Tamara J Oneal (OWNER) |
| Authorized Official Contact | 3257639906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tammy O'neal, Llc 7962 S Country Club Rd San Angelo TX 76904-7987 Ph: (325) 763-9906 | Tammy O'neal, Llc 3131 Executive Dr San Angelo TX 76904-6801 Ph: (325) 763-9906 |
| NPI Number | 1962229799 |
|---|---|
| Provider Enumeration Date | 09/23/2024 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/23/2024 |
| Medicare PECOS PAC ID | 7214461755 |
|---|---|
| Medicare Enrollment ID | O20241106003654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962229799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Tamara J O'neal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871211094 PECOS PAC ID: 2365899887 Enrollment ID: I20231106001091 |
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