Active NPI
Gabriel Dominguez, M.S., LPC
- Professional Counselor
- Dallas, TX
National Provider Identifier
1235406281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 63616
- Practice address
- 710 Cheyenne Rd
Dallas, TX 75217-3611 - Phone
- (214) 502-4080
- Fax
- (972) 502-4099
- NPI assigned
- Nov 18, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 63616 | TX | Primary |
Addresses
Primary practice location
710 Cheyenne Rd
Dallas, TX 75217-3611
Mailing address
PO Box 35464
Dallas, TX 75235-0464
Other practice location 1
1025 S Jupiter Rd
Garland, TX 75042-7708
Phone (972) 272-4429
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 304518902 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63616 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Galaxy Counseling Center | Past | Accepting new patients | |
| Galaxy Counseling Center | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Garland, TX
- NPI 1184854945
-
- Mental Health Counselor
- Garland, TX
- NPI 1730249368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538352000000",
"number": "1235406281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35464",
"city": "DALLAS",
"state": "TX",
"postal_code": "752350464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 CHEYENNE RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752173611",
"telephone_number": "214-502-4080",
"fax_number": "972-502-4099"
}
],
"practiceLocations": [
{
"address_1": "1025 S Jupiter Rd",
"address_purpose": "LOCATION",
"city": "Garland",
"state": "TX",
"postal_code": "750427708",
"country_code": "US",
"telephone_number": "972-272-4429",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "GABRIEL",
"credential": "M.S., LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-18",
"last_updated": "2018-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "63616",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "304518902",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.