Individual
DR. DOMINIQUE VANDE MAELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100B E ALTON GLOOR BLVD, STE 260, BROWNSVILLE, TX 78526-3376
(956) 350-3901
(956) 350-3900
Mailing address
100B E ALTON GLOOR BLVD, STE 260, BROWNSVILLE, TX 78526-3376
(956) 350-3901
(956) 350-3900
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K3511
TX
208C00000X
Colon & Rectal Surgery Physician
K3511
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030137601
—
TX
05
—
030137602
—
TX
Enumeration date
09/20/2006
Last updated
02/09/2022
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