Provider Demographics
NPI:1245109529
Name:DOMINGUEZ, JOHN CHARLES JR (EMT-P, ATP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHARLES
Last Name:DOMINGUEZ
Suffix:JR
Gender:M
Credentials:EMT-P, ATP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:104 SHEFFIELD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-2625
Mailing Address - Country:US
Mailing Address - Phone:910-578-1274
Mailing Address - Fax:
Practice Address - Street 1:104 SHEFFIELD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-2625
Practice Address - Country:US
Practice Address - Phone:910-578-1274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1922065234207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine