Colette M Dominique MD PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

L9182 Issued in TX

Legal business name

COLETTE M DOMINIQUE MD PA

Practice address

3501 N Macarthur Blvd
Suite 500
Irving, TX 75062-3636

Phone

(972) 256-3700

Fax

(972) 258-9887

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Colette Dominique, MD PA

Title

President

Phone

(972) 256-3700

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203638400000",
    "number": "1508971771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 N MACARTHUR BLVD",
            "address_2": "SUITE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623636",
            "telephone_number": "972-256-3700",
            "fax_number": "972-258-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N MACARTHUR BLVD",
            "address_2": "SUITE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623636",
            "telephone_number": "972-256-3700",
            "fax_number": "972-258-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLETTE M DOMINIQUE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2008-02-22",
        "status": "A",
        "authorized_official_last_name": "DOMINIQUE",
        "authorized_official_first_name": "COLETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-256-3700",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "L9182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0024QS",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Irving, TX
• Providers in Irving, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; 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.