Provider Demographics
NPI:1194405142
Name:SPEAR, DOMINIQUE NICOLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DOMINIQUE
Middle Name:NICOLE
Last Name:SPEAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 ORIOLE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6000
Mailing Address - Country:US
Mailing Address - Phone:956-990-8801
Mailing Address - Fax:
Practice Address - Street 1:10718 POTRANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3312
Practice Address - Country:US
Practice Address - Phone:210-681-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist