Individual
DOMINIQUE GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 S SUNSET AVE, LITTLEFIELD, TX 79339-4899
(806) 385-6411
Mailing address
1500 S SUNSET AVE, LITTLEFIELD, TX 79339-4899
(806) 385-6411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
T2166
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/14/2019
Last updated
06/17/2022
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