Organization
JORGE E. DOMINGUEZ MD PA
Active
Other names
Brownsville Pediatric & Adolescent Care
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIA R DOMINGUEZ (ADMINISTRATOR)
(956) 548-1100
Entity
Organization
Contact information
Practice address
3150 INTERNATIONAL BLVD, BROWNSVILLE, TX 78521-3214
(956) 548-1100
(956) 504-1907
Mailing address
3150 INTERNATIONAL BLVD, BROWNSVILLE, TX 78521-3214
(956) 548-1100
(956) 504-1907
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084901001
—
TX
05
—
08490101.02
—
TX
05
—
091753602
—
TX
05
—
1538208038
—
TX
Enumeration date
12/04/2006
Last updated
05/26/2010
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