Theresa Elizabeth Dominguez, RN IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

L-166288 Issued in TX

Practice address

12777 Jones Rd Ste 440
Houston, TX 77070-4600

Phone

(281) 305-0411

NPI assigned

Jun 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Theres Elizabeth Reyes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1396477030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 LAKEVILLE DR STE 304",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392694",
            "telephone_number": "281-305-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12777 JONES RD STE 440",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704600",
            "telephone_number": "281-305-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "THERESA",
        "middle_name": "ELIZABETH",
        "credential": "RN IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "781135",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TX",
            "license": "L-166288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERES",
            "last_name": "REYES",
            "middle_name": "ELIZABETH",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mercedes Maria Dominguez, M.ED., LPC
• Michael Anthony Dominguez I, RPH
• Misti-Rae Isabel Dominguez, APRN, FNP-C
• Paula Valeria Dominguez
• Selene Mendoza Dominguez, FNP
• Wilfrido Omar Dominguez, M.D.
• Dominic Sreshta , MD.,PA .
• John T Dominici, DDS, MS
• Melissa Seman Dominick, CRNA
• Dominion Medical Healthcare Service

• Lactation Consultant (Registered Nurse) in Houston, TX
• Providers in Houston, TX by specialty
• Lactation Consultant (Registered Nurse) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.