# DOMINION MEDICAL HEALTHCARE SERVICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255567848
- **Authorized official:** IRENONA WATSON (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (281) 974-4400

## Contact information

- **Practice address:** 8300 BISSONNET ST, SUITE 130, HOUSTON, TX 77074-3900
- **Practice address phone:** (281) 974-4400
- **Practice address fax:** (281) 974-4386
- **Mailing address:** 8300 BISSONNET ST, SUITE 130, HOUSTON, TX 77074-3900
- **Mailing address phone:** (281) 974-4400
- **Mailing address fax:** (281) 974-4386

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133N00000X | Nutritionist | — | NULL | — |
| 133N00000X | Nutritionist | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |
| 247100000X | Radiologic Technologist | — | NULL | — |
| 247100000X | Radiologic Technologist | — | — | — |
| 363A00000X | Physician Assistant | PA 03172 | TX | — |

## Other

- **Enumeration date:** 06/09/2009
- **Last updated:** 08/25/2009