Active NPI
Marco Antonio Vasquez Dominguez
- Pharmacist
- Austin, TX
National Provider Identifier
1730965112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 73075
- Practice address
- 8040 Mesa Dr
Austin, TX 78731-1319 - Phone
- (512) 345-7238
- NPI assigned
- Sep 1, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 73075 | TX | Primary |
Addresses
Primary practice location
8040 Mesa Dr
Austin, TX 78731-1319
Mailing address
11119 Alterra Pkwy Apt 2394
Austin, TX 78758-0026
Phone (469) 285-3520
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 |
|---|---|---|---|
| 73075 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693526400000",
"number": "1730965112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11119 ALTERRA PKWY APT 2394",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787580026",
"telephone_number": "469-285-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8040 MESA DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787311319",
"telephone_number": "512-345-7238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "MARCO ANTONIO",
"middle_name": "VASQUEZ",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-01",
"last_updated": "2023-09-01",
"certification_date": "2023-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "73075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.