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Individual

DOMINA NYINAWINYANGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
(352) 265-8002
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA09929
TX
363AM0700X
Medical Physician Assistant
PA60318338
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104026200
FL
Enumeration date
11/09/2012
Last updated
11/29/2023
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