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NPI Code Detail

MEDICARE: DOMINGO AGUIRRE DOMINGUEZ

MEDICARE: DOMINGO AGUIRRE DOMINGUEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant210192TX

General Provider Information

NPI Number : 1134600646
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMINGO AGUIRRE DOMINGUEZ
Provider Business Mailing Address
First Line : 1008 W ROCKPORT ST
Second Line :
City : MATHIS
State : TX
Zip : 78368-2161
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 696 FM 99
Second Line :
City : KARNES CITY
State : TX
Zip : 78118-5009
Country : US
Telephone Number : 830-780-3944
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2018
Last Update Date : 08/23/2018

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Directions to “ DOMINGO AGUIRRE DOMINGUEZ ” Practice Location

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