Tabatha Dominguez, NURSE PRACTITIONER | |
3200 Avenue E, Hondo, TX 78861-3525 | |
(830) 426-7444 | |
Not Available |
Full Name | Tabatha Dominguez |
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Gender | Female |
Speciality | Nurse Practitioner |
Location | 3200 Avenue E, Hondo, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407325731 | NPI | - | NPPES |
AP139722 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | AP139722 (Texas) | Primary |
Entity Name | Vmd Primary Providers South Hill Country Texas, Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902400880 PECOS PAC ID: 4284048646 Enrollment ID: O20210126000756 |
Mailing Address | Practice Location Address |
---|---|
Tabatha Dominguez, NURSE PRACTITIONER Po Box 752, Hondo, TX 78861-0752 Ph: (830) 931-5008 | Tabatha Dominguez, NURSE PRACTITIONER 3200 Avenue E, Hondo, TX 78861-3525 Ph: (830) 426-7444 |
Meaghan Nicol Timberlake, APRN, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 602 31st St, Hondo, TX 78861 Phone: 210-202-0250 Fax: 830-331-2287 | |
Mary Luisa Ramos, CNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 3100 Avenue E, Hondo, TX 78861 Phone: 830-426-7444 Fax: 830-426-7467 |