Provider Demographics
NPI:1134482219
Name:DOMINGUEZ, CRISTIAN ENRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:ENRIQUE
Last Name:DOMINGUEZ
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 1:7703 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-567-4928
Mailing Address - Fax:
Practice Address - Street 1:929 GESSNER RD STE 1360
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2469
Practice Address - Country:US
Practice Address - Phone:713-468-2030
Practice Address - Fax:713-468-1940
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR73233207R00000X
TXR7984207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine