NPIMap

Organization Active NPI

Russell Doubrava DO PA

  • Urology Physician
  • Decatur, TX
National Provider Identifier
1639135452
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
RUSSELL DOUBRAVA DO PA
Practice address
2010 Ben Merritt Dr
Ste B
Decatur, TX 76234
Phone
(940) 627-0088
Fax
(940) 627-0288
NPI assigned
Apr 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Russell G Doubrava, DONPI 1992761712
Title
President
Phone
(940) 627-0088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

2010 Ben Merritt Dr
Ste B
Decatur, TX 76234

Mailing address

2010 Ben Merritt Dr
Ste B
Decatur, TX 76234
Phone (940) 627-0088

Other identifiers 1

IdentifierTypeStateIssuer
0072MUOtherBCBS

National Provider Directory

National Provider Directory

Locations

2010 Ben Merritt Dr
Unit B
Decatur, TX 76234
Phone (940) 626-4683

2451 S FM 51
Ste 100
Decatur, TX 76234
Phone (940) 627-0088

Interoperability endpoints

  • Direct secure messaging: russelldoubrava@doubravauro.medalliesdirect.net

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639135452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 BEN MERRITT DR",
            "address_2": "STE B",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "76234",
            "telephone_number": "940-627-0088",
            "fax_number": "940-627-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BEN MERRITT DR",
            "address_2": "STE B",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "76234",
            "telephone_number": "940-627-0088",
            "fax_number": "940-627-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL DOUBRAVA DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOUBRAVA",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-627-0088",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0072MU",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.