Active NPI
Dominic Mariscal
- Physical Therapist
- Humble, TX
National Provider Identifier
1558116152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1385246
- Practice address
- 15431 Cordach Dr
Humble, TX 77346-4766 - Phone
- (713) 386-9947
- NPI assigned
- Apr 18, 2024
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1385246 | TX | Primary |
Addresses
Primary practice location
15431 Cordach Dr
Humble, TX 77346-4766
Mailing address
15431 Cordach Dr
Humble, TX 77346-4766
Phone (713) 386-9947
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 |
|---|---|---|---|
| 1385246 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713398400000",
"number": "1558116152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15431 CORDACH DR",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773464766",
"telephone_number": "713-386-9947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15431 CORDACH DR",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773464766",
"telephone_number": "713-386-9947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARISCAL",
"first_name": "DOMINIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-18",
"last_updated": "2024-04-18",
"certification_date": "2024-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1385246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humble, TX
- Mark Anthony Marbach, DDS
- Lydia Marcelle, PHARMD
- Caroline A Marcus, MD
- Maria S Dsouza Ms MD
- Michelle Navalance Mariani, M.S., CCC-SLP
- Mark H. Rinkoff, O.D. and Associates, a Professional Corporation
- Mark H. Rinkoff, OD, PC
- Mark R Richardson RPH OD PC
- Thania Lizeth Marquez
- Willie Matthew Marquez, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.