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General NPI Number Information
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NPI Number | 1134482219
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Entity Type | Individual
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Provider Name | CRISTIAN ENRIQUE DOMINGUEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2012
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 929 GESSNER RD STE 1360
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City | HOUSTON
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State | TX
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Zip | 77024-2469
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Country | US
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Telephone | 713-468-2030
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Fax | 713-468-1940
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Provider Business Mailing Address
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Address Line | 7703 FLOYD CURL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3901
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Country | US
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Telephone | 210-567-4928
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R73233
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | R7984
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License Number State | TX
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