Individual provider Active NPI

Simon Domenech, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1174862312
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09745 Issued in TX
Practice address
8210 Floyd Curl Dr
San Antonio, TX 78229-3923
Phone
(210) 450-3100
NPI assigned
Feb 7, 2013
Last updated
Jun 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09745 TX Primary

Addresses

Primary practice location

8210 Floyd Curl Dr
San Antonio, TX 78229-3923

Mailing address

8210 Floyd Curl Dr
San Antonio, TX 78229-3923
Phone (210) 450-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250319002594 TX Practitioner - Physician Assistant 4981126976 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA09745TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Provider Group PLLC CurrentSince Mar 10, 2025 Accepting new patients
TMC Provider Group PLLC CurrentSince Mar 10, 2025 Accepting new patients

Locations

9900 S Interstate 35
Austin, TX 78748
Phone (512) 291-5577

13722 Embassy Row
San Antonio, TX 78216
Phone (210) 349-5577

23611 W Interstate 10
San Antonio, TX 78257
Phone (210) 698-6617

Interoperability endpoints

  • Direct secure messaging: sdomenech66587@direct.utmsa.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1174862312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293923",
            "telephone_number": "210-450-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8210 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293923",
            "telephone_number": "210-450-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMENECH",
        "first_name": "SIMON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-07",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.