Maria G Dominguez, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

F9295 Issued in TX

Practice address

12050 Vance Jackson Rd
San Antonio, TX 78230-1182

Phone

(210) 699-8881

Fax

(210) 699-0503

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of California, Geffen School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Bexar County Board of Trustees for Mental Health Mental Retardation

  • Counselor
  • San Antonio, TX
  • NPI 1730134586
  NPD (past)
• STBM LLC

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1992921019
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1891738449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12050 VANCE JACKSON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301182",
            "telephone_number": "210-699-8881",
            "fax_number": "210-699-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12050 VANCE JACKSON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301182",
            "telephone_number": "210-699-8881",
            "fax_number": "210-699-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MARIA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "F9295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131203507",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Dominguez
• Jasmine Dominguez
• John Charles Dominguez Jr., EMT-P, ATP
• Julio Mata Dominguez, LCDC
• Leticia Lagunas Dominguez, LCSW
• Maria Guadalupe Dominguez, LVN
• Michael Joseph Dominguez, MD
• Miranda Kaye Dominguez, LVN
• Olivia M Dominguez, LVN
• Patricia Dominguez

• Child & Adolescent Psychiatry Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Child & Adolescent Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.