Provider Demographics
NPI:1548545460
Name:DOMINGUEZ, ROBERT P JR (LPC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:P
Last Name:DOMINGUEZ
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5408 ANAHEIM AVE
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4887
Mailing Address - Country:US
Mailing Address - Phone:512-779-8267
Mailing Address - Fax:
Practice Address - Street 1:13201 HIGH SIERRA ST
Practice Address - Street 2:
Practice Address - City:MANOR
Practice Address - State:TX
Practice Address - Zip Code:78653-5378
Practice Address - Country:US
Practice Address - Phone:512-779-8267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66156101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional