IVAN DOMINGUEZ

FORT SAM HOUSTON, TX
NPI1083065130
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: TX  1335011)
Enumeration Date2016-06-29
Last Update Date2023-11-02
Business Address
IVAN DOMINGUEZ SPT ATC LAT
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234-4504
Phone number: 210-916-5658
Mailing Address
IVAN DOMINGUEZ SPT ATC LAT
3698 CHAMBERS PASS BLDG 3611
SAN ANTONIO, TX 78234-7766
Phone number: 210-916-5658