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General NPI Number Information
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NPI Number | 1942885298
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Entity Type | Individual
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Provider Name | DOMINGO BAEZ-DIAZ DNP, ACNP/CNS
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Gender | Male
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-916-9432
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Fax |
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Provider Business Mailing Address
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Address Line | 811 NIEBLA CRK
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City | SAN ANTONIO
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State | TX
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Zip | 78263-6059
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Country | US
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Telephone | 210-376-9517
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R196970
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | R196970
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | CS00172
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License Number State | MD
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