Provider Demographics
NPI:1306422993
Name:ARNOLD, DOMINIQUE KARL (CRNA)
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:KARL
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N MCCOLL RD APT 42127
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-0063
Mailing Address - Country:US
Mailing Address - Phone:956-249-3005
Mailing Address - Fax:
Practice Address - Street 1:DHR HEALTH
Practice Address - Street 2:5501 S MCCOLL RD
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-362-8677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX830195367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty