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Individual

DAVID C DOMINGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
(254) 215-9722

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08910
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
339986704
TX
01
339986705
CSHCN
TX
Enumeration date
12/30/2013
Last updated
07/07/2025
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