Fernando Dominguez, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT6919 Issued in TX

Practice address

1130 Beachview St
Dallas, TX 75218-3700

Phone

(469) 341-5676

NPI assigned

Nov 22, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1164936555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9730 ASH CREEK DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752283602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 BEACHVIEW ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183700",
            "telephone_number": "469-341-5676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9730 Ash Creek dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75228",
            "country_code": "US",
            "telephone_number": "214-668-3664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "FERNANDO",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janetci Liliana Dominguez Arevalo Palacios, LCSW
• Yesenia Dominguez Pereira, LCSW
• Arturo Ricardo Dominguez, MD
• Cynthia Dominguez, LPC
• Edward A Dominguez, M.D.
• Gabriel Dominguez, M.S., LPC
• Jeanette Dominguez, LPC
• Manuel Dominguez, M.D.
• Maria Connie Dominguez
• Nicole Dominguez

• Athletic Trainer in Dallas, TX
• Providers in Dallas, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.