Organization Active NPI

Roland J. Dominguez M.D., P.a.

  • Primary Care Clinic/Center
  • San Antonio, TX
National Provider Identifier
1679846430
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
H3874 Issued in TX
Legal business name
ROLAND J. DOMINGUEZ M.D., P.A.
Practice address
2829 Babcock Rd
Suite #407
San Antonio, TX 78229-6028
Phone
(210) 614-5437
Fax
(210) 949-5051
NPI assigned
Feb 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Authorized official

Name
Dr. Roland J Dominguez, M.D.
Title
President
Phone
(956) 492-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X H3874 TX Primary

Addresses

Primary practice location

2829 Babcock Rd
Suite #407
San Antonio, TX 78229-6028

Mailing address

2829 Babcock Rd
Suite #407
San Antonio, TX 78229-6028
Phone (210) 614-5437

Other identifiers 1

IdentifierTypeStateIssuer
124696905MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340323200000",
    "number": "1679846430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD",
            "address_2": "SUITE #407",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296028",
            "telephone_number": "210-614-5437",
            "fax_number": "210-949-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD",
            "address_2": "SUITE #407",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296028",
            "telephone_number": "210-614-5437",
            "fax_number": "210-949-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLAND J. DOMINGUEZ M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-06-22",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-492-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "H3874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124696905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; 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.