Provider Demographics
NPI:1275025983
Name:PALOMO, DOMINGO III (NP-C)
Entity Type:Individual
Prefix:MR
First Name:DOMINGO
Middle Name:
Last Name:PALOMO
Suffix:III
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 N 86TH ST
Mailing Address - Street 2:UT HEALTH RGV PRIMARY CARE SAN CARL
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-0012
Mailing Address - Country:US
Mailing Address - Phone:956-296-1711
Mailing Address - Fax:956-296-1710
Practice Address - Street 1:230 N 86TH ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-0012
Practice Address - Country:US
Practice Address - Phone:956-296-1711
Practice Address - Fax:956-296-1710
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130869363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health