Dominguez, Maria G

Dominguez, Maria G is an sole proprietor health care provider with primary practice located at 12050 Vance Jackson Rd , San Antonio TX 78230-1182. She recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as her primary health care specialty. Dominguez, Maria G can be contacted via phone (210) 699-8881.

Contact Information

Primary practice address
12050 Vance Jackson Rd San Antonio TX 78230-1182
Phone: (210) 699-8881
Fax: (210) 699-0503
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X F9295 Texas

Profile Details

NPI number 1891738449
LBN Legal business name Dominguez, Maria G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 13th, 2006
Last updated Sep 6th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891738449 NPPES
Texas MEDICAID 131203507

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