Individual provider Active NPI

Dominic Liguori, NP

  • Family Nurse Practitioner
  • Boerne, TX
National Provider Identifier
1669063970
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1020674 Issued in TX
Practice address
625 N Main St
Boerne, TX 78006-1621
Phone
(512) 237-4606
Fax
(956) 928-9532
NPI assigned
Jan 29, 2021
Reactivated
Mar 16, 2026
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1020674 TX Primary

Addresses

Primary practice location

625 N Main St
Boerne, TX 78006-1621

Mailing address

1908 N Laurent St Ste 250
Victoria, TX 77901-5417
Phone (361) 576-0694

Other practice location 1

602 Babcock Rd
San Antonio, TX 78201-3101
Phone (210) 731-1000

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1020674TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1669063970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 N LAURENT ST STE 250",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015417",
            "telephone_number": "361-576-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N MAIN ST",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780061621",
            "telephone_number": "512-237-4606",
            "fax_number": "956-928-9532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Babcock Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782013101",
            "country_code": "US",
            "telephone_number": "210-731-1000",
            "fax_number": "956-928-9532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIGUORI",
        "first_name": "DOMINIC",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "deactivation_date": "2022-02-07",
        "reactivation_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1020674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.