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NPI Code Detail

MEDICARE: AURORA DOMINGUEZ OTR/L

MEDICARE: AURORA DOMINGUEZ OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist119771TX

General Provider Information

NPI Number : 1558925925
Entity Type Code : Individual
Provider Name (Legal Business Name) : AURORA DOMINGUEZ OTR/L
Provider Business Mailing Address
First Line : 217 CANSIGLIO
Second Line :
City : CIBOLO
State : TX
Zip : 78108-1948
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 150 W SUNSET RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-2633
Country : US
Telephone Number : 210-998-2597
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2019
Last Update Date : 04/30/2019

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Directions to “ AURORA DOMINGUEZ OTR/L” Practice Location

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