RUSSELL DOUBRAVA DO PA (NPI# 1639135452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639135452 |
| Entity Type | Organization |
| Organization Name | RUSSELL DOUBRAVA DO PA |
| Practice Address |
2010 Ben Merritt Dr Ste B Decatur TX 76234 |
| Practice Telephone | 9406270088 |
| Practice Fax Number | 9406270288 |
| Mailing Telephone | 9406270088 |
| Mailing Fax Number | 9406270288 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RUSSELL G DOUBRAVA (PRESIDENT) |
| Authorized Official Telephone | 9406270088 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 0072MU | 01 |
| Street Address |
2010 BEN MERRITT DR STE B |
| City | DECATUR |
| State | TX |
| Zip Code | 76234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083126825 | Jamie Linn Rogers | Nurse Practitioner | 2010 Ben Merritt Dr, Decatur, TX 76234-3854 | 2017-11-02 |
| 1427416064 | Chanin Owen | Nurse Practitioner | 2010 Ben Merritt Dr, Suite A, Decatur, TX 76234-3854 | 2016-02-09 |
| 1104112523 | Linda Marie Schaefer | Physician Assistant | 2010 Ben Merritt Dr, Decatur, TX 76234-3854 | 2011-06-23 |
| 1053571091 | Dallas Oncology Consultants Pa | Internal Medicine | 2010 Ben Merritt Dr, Suite A, Decatur, TX 76234-3854 | 2008-06-12 |
| 1366549735 | Neelima Maddukuri | Internal Medicine | 2010 Ben Merritt Dr, Suite A, Decatur, TX 76234-3854 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477102028 | Ursula Eileen Fernandez-plata | Technician | 1221 Cr 4371, Decatur, TX 76234 | 2019-09-06 |
| 1649772377 | Stephanie Jennie Roddenberry | Nurse Practitioner | 2301 S Fm 51 Ste 500, Decatur, TX 76234 | 2018-03-08 |
| 1467731679 | David Gatti Corless | Dentist | 301 W. Main St., Decatur, TX 76234 | 2011-08-05 |
| 1376830067 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 805 W Business Hwy 380, Decatur, TX 76234 | 2011-07-01 |
| 1356667844 | Richard Ryan Ooten | Specialist/Technologist, Other | 239 Harvey Lane, Decatur, TX 76234 | 2010-04-09 |
| 1003049032 | Advanced Gastroenterology Associates, Pa | Internal Medicine | 607 Medical Center Drive, Suite 2600, Decatur, TX 76234 | 2009-08-25 |
| 1831346188 | Rufus John Nelson | Dentist | 1710 S Hwy 51 Ste 20,pmb #176, 1000 W Business Hwy 380, Decatur, TX 76234 | 2008-08-19 |
| 1851558449 | James Lee Hendrick | Counselor | 2304 Fm 51 South, Decatur, TX 76234 | 2008-05-21 |
| 1891964995 | Sheryl A White | Counselor | 1106 E Business Hwy 380, Decatur, TX 76234 | 2008-02-22 |
| 1366625022 | Tower Mutual Holding Company, Inc. | Durable Medical Equipment & Medical Supplies | 206 N. State Street, Decatur, TX 76234 | 2007-12-17 |
| Find all providers in zip 76234 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932451093 | Samuel Britt Owens | Urology | 2320 Brookwood Dr Se, Decatur, AL 35601-6176 | 2012-10-12 |
| 1245505536 | Urology Associates of North Alabama | Urology | 1874 Beltine Road, Sw, Suite 106, Decatur, AL 35601 | 2012-03-20 |
| 1912183443 | Syed Mohammad Akbar Jafri | Urology | 3002 Mount Olive Dr, Decatur, GA 30033-3016 | 2008-01-15 |
| 1114138104 | Alabama Urology and Robotics Center | Urology | 1210 14th Avenue South East, Decatur, AL 35601 | 2007-05-24 |
| 1518903988 | Karl L Pete | Urology | 2711 Irvin Way Ste 102, Decatur, GA 30030 | 2006-06-22 |
| 1053366641 | William E Hughes | Urology | 1210 14th Ave Se, Suite G200, Decatur, AL 35601 | 2006-05-23 |
| 1992761712 | Russell Gene Doubrava | Urology | 2451 S Fm 51, Suite 100, Decatur, TX 76234 | 2006-04-21 |
| 1063411304 | Lee G Endsley | Urology | 302 W Hay St, Ste 200, Decatur, IL 62526-4167 | 2005-07-19 |
| 1871144246 | Georgia Urology Pa | Urology | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-09-26 |
| 1134642200 | Advanced Urology Institute of Georgia | Urology | 2711 Irvin Way, Decatur, GA 30030-5405 | 2017-07-20 |
| Find all providers in DECATUR | ||||
Please comment or provide details below to improve the information on RUSSELL DOUBRAVA DO PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.