Provider Demographics
NPI:1588440150
Name:DOMINGUEZ, SARAH JAMDAR (APRN, CPNP-AC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JAMDAR
Last Name:DOMINGUEZ
Suffix:
Gender:F
Credentials:APRN, CPNP-AC
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1408 KAMRYN WAY
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-1260
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4410 MEDICAL DR STE 540
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3755
Practice Address - Country:US
Practice Address - Phone:210-575-6240
Practice Address - Fax:210-575-6280
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1135422363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner