Individual
DR. DMITRIY GROMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
P O B 840853, DALLAS, TX 75284
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
25MB10798200
NJ
207L00000X
Anesthesiology Physician
Primary
S8833
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/29/2015
Last updated
08/09/2021
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