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RUSSELL DOUBRAVA DO PA NPI 1639135452


NPI Information

NPI: 1639135452
Provider Name: RUSSELL DOUBRAVA DO PA
Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 45D1043715

Address:
2010 BEN MERRITT DR
STE B
DECATUR, TX
ZIP 76234
Phone: (940) 627-0088
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RUSSELL DOUBRAVA DO PA is an urology in Decatur, TX. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. RUSSELL DOUBRAVA DO PA NPI is 1639135452. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2010 BEN MERRITT DR
STE B
DECATUR, TX
ZIP 76234
Phone: (940) 627-0088
Fax: (940) 627-0288

The provider's authorized official is Russell G Doubrava .
The authorized official title is President and has the following contact phone number (940) 627-0088.

The CLIA number assigned to this NPI record is 45D1043715 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/21/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10072MUOTHERBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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