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General NPI Number Information
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NPI Number | 1366926297
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Entity Type | Organization
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Legal Business Name | DOMINANT RESIDENCE LLC
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Dates
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Enumeration Date | 09/17/2018
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 1428 MAC ARTHUR DR STE 101
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City | CARROLLTON
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State | TX
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Zip | 75007-4437
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Country | US
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Telephone | 214-840-9157
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 RIVERS CREEK LN
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City | LITTLE ELM
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State | TX
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Zip | 75068-2907
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TEMISAN SMART
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Credential |
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Telephone | 214-840-9157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347D00000X
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Taxonomy Name | Train
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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