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Individual

DR. DONALD DEAN DOMINY III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
16811 SOUTHWEST FWY, SUGAR LAND, TX 77479-4728
(281) 690-4678
Mailing address
16811 SOUTHWEST FWY, SUGAR LAND, TX 77479-4728
(281) 690-4678

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
N1615
TX
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
N1615
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1336370527
BLUE CROSS BLUE SHIELD
TX
05
307642401
TX
05
307642402
TX
05
307642403
TX
05
307642404
TX
05
307642405
TX
05
307642406
TX
01
P01170515
RR MEDICARE
TX
01
P01258412
MEDICARE RR
TX
Enumeration date
08/05/2009
Last updated
06/10/2019
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