Active NPI
David Eugene Domelsmith, PHD
- Clinical Child & Adolescent Psychologist
- Fort Hood, TX
National Provider Identifier
1982813952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 24165
- Practice address
- 36000 Darnall Loop
Crdamc, Box 46, Child and Adolescent Psychiatry
Fort Hood, TX 76544-5095 - Phone
- (254) 288-8731
- Fax
- (254) 286-7629
- NPI assigned
- May 22, 2007
- 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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 24165 | TX | Primary |
Addresses
Primary practice location
36000 Darnall Loop
Crdamc, Box 46, Child and Adolescent Psychiatry
Fort Hood, TX 76544-5095
Mailing address
Carl R. Darnall Army Medical Center, 36000 Darnall Loop
Child and Adolescent Psychiatry, Box 46
Fort Hood, TX 76544
Phone (254) 288-8731
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24165 | TX | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982813952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CARL R. DARNALL ARMY MEDICAL CENTER, 36000 DARNALL LOOP",
"address_2": "CHILD AND ADOLESCENT PSYCHIATRY, BOX 46",
"city": "FORT HOOD",
"state": "TX",
"postal_code": "76544",
"telephone_number": "254-288-8731",
"fax_number": "254-286-7629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36000 DARNALL LOOP",
"address_2": "CRDAMC, BOX 46, CHILD AND ADOLESCENT PSYCHIATRY",
"city": "FORT HOOD",
"state": "TX",
"postal_code": "765445095",
"telephone_number": "254-288-8731",
"fax_number": "254-286-7629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMELSMITH",
"first_name": "DAVID",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "TX",
"license": "24165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Hood, TX
Sources for this page
- 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.