Individual
ROBERTO DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1154 E PALMA VISTA DR, PALMVIEW, TX 78572-2029
(956) 862-1813
Mailing address
1154 E PALMA VISTA DR, PALMVIEW, TX 78572-2029
(956) 862-1813
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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