Individual provider Active NPI

Walter Albert Dobson, DO

  • Surgery Physician
  • Grand Prairie, TX
National Provider Identifier
1720168958
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
34002298 Issued in OH
Practice address
647 S Great Southwest Parkway
Suite 105
Grand Prairie, TX 75051
Phone
(972) 660-3188
Fax
(972) 602-0613
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS3512 FL
Surgery Physician 208600000X 34002298 OH Primary
Plastic and Reconstructive Surgery Physician 2086S0122X F2636 TX

Addresses

Primary practice location

647 S Great Southwest Parkway
Suite 105
Grand Prairie, TX 75051

Mailing address

647 S Great Southwest Parkway
Suite 105
Grand Prairie, TX 75051
Phone (972) 660-3188

Other identifiers 1

IdentifierTypeStateIssuer
P000FE048MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS3512FLMDSurgery Physician
34002298OHMDSurgery Physician
F2636TXMDPlastic and Reconstructive Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1720168958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 S GREAT SOUTHWEST PARKWAY",
            "address_2": "SUITE 105",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75051",
            "telephone_number": "972-660-3188",
            "fax_number": "972-602-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 S GREAT SOUTHWEST PARKWAY",
            "address_2": "SUITE 105",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75051",
            "telephone_number": "972-660-3188",
            "fax_number": "972-602-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBSON",
        "first_name": "WALTER",
        "middle_name": "ALBERT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS3512",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34002298",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "F2636",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P000FE048",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.