| Dominion Family Healthcare Pllc | |
|
23119 W Interstate 10 Bldg 9 San Antonio TX 78257-1689 | |
| (254) 629-2747 | |
| (888) 630-1983 |
| Full Name | Dominion Family Healthcare Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 23119 W Interstate 10 Bldg 9, San Antonio, Texas |
| Authorized Official Name and Position | Kelly E Skinner (BILLING/CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2546292747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dominion Family Healthcare Pllc 25843 Scenic Rock San Antonio TX 78255-2373 Ph: (254) 629-2747 | Dominion Family Healthcare Pllc 23119 W Interstate 10 Bldg 9 San Antonio TX 78257-1689 Ph: (254) 629-2747 |
| NPI Number | 1669972659 |
|---|---|
| Provider Enumeration Date | 02/15/2018 |
| Last Update Date | 02/15/2018 |
| Medicare PECOS PAC ID | 9335486695 |
|---|---|
| Medicare Enrollment ID | O20190124000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669972659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rashid Atique |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386077378 PECOS PAC ID: 8123319068 Enrollment ID: I20160830001435 |
| Provider Name | Yasmeen T Agha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164865762 PECOS PAC ID: 2961784087 Enrollment ID: I20170126000164 |
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