Organization
RICARDO DOMINGUEZ, LSA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICARDO DOMINGUEZ JR. (LSA)
(972) 281-7992
Entity
Organization
Contact information
Practice address
2024 HIGHRIDGE LN, MIDLOTHIAN, TX 76065
(972) 281-7992
Mailing address
2024 HIGHRIDGE LN, MIDLOTHIAN, TX 76065
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00529
TX
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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