Healthcare Provider Details

I. General information

NPI: 1770559114
Provider Name (Legal Business Name): JOSEPH ARTHUR DOMINGUEZ III APA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2006
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 W OAKLAWN RD
PLEASANTON TX
78064-4609
US

IV. Provider business mailing address

22331 SAVANNAH LK
VON ORMY TX
78073-3022
US

V. Phone/Fax

Practice location:
  • Phone: 830-569-1950
  • Fax:
Mailing address:
  • Phone: 210-860-7214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: