Individual
ATINUKE ANTHONIA DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22135 LEIROP DR, RICHMOND, TX 77407-2974
(832) 228-5997
Mailing address
22135 LEIROP DR, RICHMOND, TX 77407-2974
(832) 228-5997
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
220512
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-407791
MEDCARE PEDIATRIC NURSING LP
TX
Enumeration date
02/20/2018
Last updated
02/20/2018
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