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NPI Code Detail

MEDICARE: DAVID HECTOR DOMINGUEZ

MEDICARE: DAVID HECTOR 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
1363A00000XPhysician AssistantTX

General Provider Information

NPI Number : 1932025632
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID HECTOR DOMINGUEZ
Provider Business Mailing Address
First Line : 2301 KRISTINA WAY
Second Line :
City : DEER PARK
State : TX
Zip : 77536-4784
Country : US
Telephone Number : 713-907-7667
Fax Number :
Provider Business Practice Location Address
First Line : 4401 BOOTH CALLOWAY RD
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-7371
Country : US
Telephone Number : 817-255-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2026
Last Update Date : 06/26/2026

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Directions to “ DAVID HECTOR DOMINGUEZ ” Practice Location

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