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General NPI Number Information
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NPI Number | 1841165347
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Entity Type | Individual
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Provider Name | DIANA FUERTE-DOMINGUEZ WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 17198 ST LUKES WAY STE 540
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City | THE WOODLANDS
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State | TX
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Zip | 77384-8016
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Country | US
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Telephone | 713-442-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 11511 SHADOW CREEK PKWY HR/CREDENTIALING SERVICES
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City | PEARLAND
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State | TX
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Zip | 77584-7298
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Country | US
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Telephone | 713-442-0000
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 1126682
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License Number State | TX
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