MEDICARE: DOMINADOR - WILLIE LLC

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
1	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1578493136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOMINADOR - WILLIE LLC

Provider Business Mailing Address
First Line	:	4835 MEDICAL DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-8001
Country	:	US
Telephone Number	:	210-617-6440
Fax Number	:

Provider Business Practice Location Address
First Line	:	7434 LOUIS PASTEUR DR STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4539
Country	:	US
Telephone Number	:	210-617-6440
Fax Number	:

Authorized Official
Title or Position	:	MANAGING EMPLOYEE
Name	:	JULIO ARAUJO
Credential	:	MD
Telephone Number	:	210-617-6440

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/26/2026

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Directions to “DOMINADOR - WILLIE LLC ” Practice Location

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