Provider Demographics
NPI:1881652436
Name:D'AUNNO, DOMINICK S (MD)
Entity Type:Individual
Prefix:DR
First Name:DOMINICK
Middle Name:S
Last Name:D'AUNNO
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 1:1708 ELMEN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-5702
Mailing Address - Country:US
Mailing Address - Phone:832-704-6500
Mailing Address - Fax:346-320-8341
Practice Address - Street 1:2401 MORSE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-6731
Practice Address - Country:US
Practice Address - Phone:281-573-0330
Practice Address - Fax:713-437-3977
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4067207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138735916Medicaid
TX183752801Medicaid
TX138735903Medicaid
TX8F3784Medicare PIN
TX138735916Medicaid