Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ivan Dominguez, SPTATCLAT

Individual provider Physical Therapist · NPI 1083065130

Ivan Dominguez, SPTATCLAT is a Physical Therapist in Fort Sam Houston, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2016

Practice location Address checks out

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone: (210) 916-5658
Fax: (210) 271-0830
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1335011 (TX)

Record details

NPI number1083065130
Entity typeIndividual (Type 1)
GenderMale
Credentials SPTATCLAT
Sole proprietorYes
NPI enumeratedJune 29, 2016
Last updated in NPPESNovember 2, 2023
Certification dateNovember 2, 2023
Mailing address3698 Chambers Pass Bldg 3611, San Antonio, TX 78234-7766

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