Provider Demographics
NPI:1497989727
Name:DOMANN, CARIN (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:CARIN
Middle Name:
Last Name:DOMANN
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 W SAM HOUSTON PKWY N
Mailing Address - Street 2:SUITE #201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3974
Mailing Address - Country:US
Mailing Address - Phone:713-465-3400
Mailing Address - Fax:713-465-3401
Practice Address - Street 1:788 W SAM HOUSTON PKWY N
Practice Address - Street 2:SUITE #201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3974
Practice Address - Country:US
Practice Address - Phone:713-465-3400
Practice Address - Fax:713-465-3401
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics