Individual
CHANDLER DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1103 SUNSET DR, ENNIS, TX 75119-2239
(972) 921-6540
Mailing address
1103 SUNSET DR, ENNIS, TX 75119-2239
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
923839
TX
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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