Organization
TYLER KIDNEY DOCTORS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT C DOBROWOLSKI M.D. (PHYSICIAN)
(903) 594-2293
Entity
Organization
Contact information
Practice address
700 OLYMPIC PLAZA CIR, 912, TYLER, TX 75701-1951
(903) 594-2293
(903) 848-9513
Mailing address
PO BOX 132506, TYLER, TX 75713-2506
(903) 594-2293
(903) 566-0167
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
J8518
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032NC
BCBS GROUP
TX
Enumeration date
10/17/2006
Last updated
03/11/2008
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