Active NPI
Chloe Dominguez
- Physical Therapy Assistant
- Midland, TX
National Provider Identifier
1265117600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4062340
- Practice address
- 3201 N Midland Dr Ste 130
Midland, TX 79707-0003 - Phone
- (432) 617-3110
- NPI assigned
- Jun 21, 2023
- Last updated
- Jun 21, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4062340 | TX | Primary |
Addresses
Primary practice location
3201 N Midland Dr Ste 130
Midland, TX 79707-0003
Mailing address
5000 Hanover Dr
Odessa, TX 79761-2239
Phone (432) 550-4700
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4062340 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1265117600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 HANOVER DR",
"city": "ODESSA",
"state": "TX",
"postal_code": "797612239",
"telephone_number": "432-550-4700",
"fax_number": "432-550-4715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 N MIDLAND DR STE 130",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797070003",
"telephone_number": "432-617-3110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "CHLOE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-21",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "4062340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.