Individual
DOMINIQUE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3625 LOGANWOOD DR, DALLAS, TX 75227-5617
(214) 682-3788
(214) 682-3788
Mailing address
3625 LOGANWOOD DR, DALLAS, TX 75227-5617
(214) 682-3788
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
TX
Enumeration date
07/23/2017
Last updated
06/16/2018
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