Individual
RICHARD TODD DOMBROSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6913 CAMP BOWIE BLVD STE 107, FORT WORTH, TX 76116-7164
(817) 367-9289
Mailing address
8332 WHIPPOORWILL DR, FORT WORTH, TX 76123-1994
(817) 412-0877
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
Q3358
TX
207Q00000X
Family Medicine Physician
Q3358
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Q3358
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344044801
—
TX
05
—
344044804
—
TX
01
—
8FA812
BCBS
TX
01
—
8FA814
BCBS
TX
01
—
P01609114
RAILROAD MEDICARE
TX
Enumeration date
01/13/2006
Last updated
08/18/2020
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