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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 25, 2024 3:48 AM CST
Next Update: Wednesday, December 25, 2024 12:00 PM CST

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DOMENECH, MANUEL ANTONIO       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: UNIVERSITY OF ST AUGUSTINE
5401 LA CROSSE AVE
AUSTIN TX 78739

Address last updated on 1/10/2017
Phone #: (737) 202-3347
Fax #:
County: NOT OKLAHOMA
License: 640
Dated: 7/12/1976
Expires: 1/31/2018
License Type: Physical Therapist
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 2018
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
UNIVERSITY OF ST AUGUSTINE
5401 LA CROSSE AVE
AUSTIN TX 78739

Phone #: (737) 202-3347
Fax #:

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