Edward Domingue, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

E1557 Issued in TX

Practice address

409 Gaslight Boulevard
Lufkin, TX 75904-3170

Phone

(936) 634-4424

Fax

(936) 634-8833

NPI assigned

Dec 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health and Human Services Commission

  • Intellectual Disabilities Intermediate Care Facility
  • Pollok, TX
  • NPI 1225117567
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619031945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 GASLIGHT BOULEVARD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043170",
            "telephone_number": "936-634-4424",
            "fax_number": "936-634-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 GASLIGHT BOULEVARD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043170",
            "telephone_number": "936-634-4424",
            "fax_number": "936-634-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUE",
        "first_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "E1557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Distinct Focus on Life, L.P. (Coats Senior Home)
• Dmctx2, PLLC
• Jennifer Nguyen Doan, O.D.
• Robert H Doan Jr., FNP
• Doctx1 PLLC (Dedicated Orthopedic Urgent Care)
• Dina Dominquez
• Down Home Care Services, LLC
• Dr Royce Read, MD and Associates
• Dr. Warren S. Guy, D.D.S., PH. D, PA (Pediatric Dentistry of East Texas)
• Dreamwise Anesthesia Associates PLLC

• Specialist in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.