Provider Demographics
NPI:1275679813
Name:HORIZON PERFUSION, P.A.
Entity Type:Organization
Organization Name:HORIZON PERFUSION, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CCP
Authorized Official - Phone:210-857-3566
Mailing Address - Street 1:24165 IH-10 WEST, STE 217
Mailing Address - Street 2:PMB 461
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1160
Mailing Address - Country:US
Mailing Address - Phone:210-857-3566
Mailing Address - Fax:210-877-9003
Practice Address - Street 1:24165 IH-10 WEST, STE 217
Practice Address - Street 2:PMB 461
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1160
Practice Address - Country:US
Practice Address - Phone:210-857-3566
Practice Address - Fax:210-877-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPF0237246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty