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General NPI Number Information
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NPI Number | 1275025983
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Entity Type | Individual
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Provider Name | DOMINGO PALOMO III NP-C
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Gender | Male
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 06/13/2023
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Provider Practice Location Address
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Address Line | 230 N 86TH ST
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City | EDINBURG
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State | TX
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Zip | 78542-0012
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Country | US
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Telephone | 956-296-1711
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Fax | 956-296-1710
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Provider Business Mailing Address
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Address Line | 230 N 86TH ST UT HEALTH RGV PRIMARY CARE SAN CARL
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City | EDINBURG
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State | TX
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Zip | 78542-0012
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Country | US
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Telephone | 956-296-1711
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Fax | 956-296-1710
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP130869
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP130869
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License Number State | TX
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