Provider Demographics
NPI:1083610265
Name:DOMINGO, RAMON K (MD)
Entity Type:Individual
Prefix:MR
First Name:RAMON
Middle Name:K
Last Name:DOMINGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1200
Mailing Address - Street 2:
Mailing Address - City:MC CAMEY
Mailing Address - State:TX
Mailing Address - Zip Code:79752-1200
Mailing Address - Country:US
Mailing Address - Phone:432-652-4010
Mailing Address - Fax:432-652-4013
Practice Address - Street 1:2500 S. HWY 305
Practice Address - Street 2:
Practice Address - City:MCCAMEY
Practice Address - State:TX
Practice Address - Zip Code:79752
Practice Address - Country:US
Practice Address - Phone:432-652-4010
Practice Address - Fax:432-652-4013
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7892207Q00000X, 207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83953FOtherBCBS PROVIDER #
TXE7892OtherLICENSE NUMBER
TX122439OtherSUPERIOR PCP #
TX82Y568OtherBCBS PROVIDER #
TX82Y568OtherBCBS PROVIDER #
TX83953FOtherBCBS PROVIDER #
TX122439OtherSUPERIOR PCP #