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General NPI Number Information
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NPI Number | 1558336537
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Entity Type | Individual
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Provider Name | DOMINGO J ROSARIO M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3851 ROGER BROOKE DRIVE, MCHE-QD (CREDS) FORT SAM HOUSTON
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City | SAN ANTONIO
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State | TX
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Zip | 78234-6200
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Country | US
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Telephone | 210-916-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 1983 OAKWELL FARMS PKWY # 1804
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City | SAN ANTONIO
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State | TX
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Zip | 78218-1724
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Country | US
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Telephone | 210-831-2275
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 01060799A
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License Number State | IN
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