Individual
MS. ELIZABETH RUTH DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
100 E FERGUSON ST STE 608, TYLER, TX 75702-5756
(903) 705-0070
(903) 405-3932
Mailing address
4615 PEAVY SWITCH RD, LUFKIN, TX 75904-7396
(469) 386-9427
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
228182
TX
Other
Enumeration date
08/03/2018
Last updated
06/11/2019
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