Provider Demographics
NPI:1598182107
Name:ENGLISH, DOMIANO
Entity Type:Individual
Prefix:
First Name:DOMIANO
Middle Name:
Last Name:ENGLISH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 LOUROCK ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-9405
Mailing Address - Country:US
Mailing Address - Phone:706-414-9354
Mailing Address - Fax:
Practice Address - Street 1:1102 LOUROCK ST
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-9405
Practice Address - Country:US
Practice Address - Phone:706-414-9354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management