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Organization
RUSSELL DOUBRAVA DO PA
Active
Organization
RUSSELL DOUBRAVA DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL G DOUBRAVA DO (PRESIDENT)
(940) 627-0088
Entity
Organization
Contact information
Practice address
2010 BEN MERRITT DR, STE B, DECATUR, TX 76234
(940) 627-0088
(940) 627-0288
Mailing address
2010 BEN MERRITT DR, STE B, DECATUR, TX 76234
(940) 627-0088
(940) 627-0288
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0072MU
BCBS
—
Enumeration date
04/21/2006
Last updated
08/22/2020
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