Provider Demographics
NPI:1396032538
Name:CASENAS, DOMINGA SIBAL (NP)
Entity Type:Individual
Prefix:
First Name:DOMINGA
Middle Name:SIBAL
Last Name:CASENAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:GAI
Other - Middle Name:SIBAL
Other - Last Name:CASENAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RNFA
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:7777 FOREST LN BLDG D
Practice Address - Street 2:STE.400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:972-566-7790
Practice Address - Fax:972-566-5819
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX675745163WR0006X
TXAP132791363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX367250301Medicaid
TX367250301Medicaid