Dominguez, Luis A

Dominguez, Luis A is an individual health care provider with primary practice located at 2400 Morthland Dr , Valparaiso IN 46383-8329. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Dominguez, Luis A can be contacted via phone (219) 465-2788.

Contact Information

Primary practice address
2400 Morthland Dr Valparaiso IN 46383-8329
Phone: (219) 465-2788
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 18003313 Indiana

Profile Details

NPI number 1528178316
LBN Legal business name Dominguez, Luis A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528178316 NPPES
Indiana MEDICAID 200485370

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