Provider Demographics
NPI:1184739534
Name:DAMBRO, NANCY N (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:N
Last Name:DAMBRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99371
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0371
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-7347
Practice Address - Street 1:1500 COOPER ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2710
Practice Address - Country:US
Practice Address - Phone:682-885-6299
Practice Address - Fax:682-885-1090
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH30122080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00257TOtherMEDICARE GROUP
TX140442852OtherMEDICAID GROUP
TX150220508OtherMEDICAID GROUP
TX4389790OtherAETNA PIN
TX89V241OtherBCBSTX IND PIN
1750369203OtherGRP NPI NUMBER
TX00U87ZOtherMEDICARE GROUP
TX1640378OtherFIRSTHEALTH PIN
TX00U87ZOtherBCBSTX GRP PIN
TX10029167OtherAMERIGROUP PIN
TX107958OtherSUPERIOR PIN
TX127419309OtherCSHCN
TX137345810OtherCSHCN GROUP
TX3064727OtherCIGNA PIN
TX127419310Medicaid
TX127419311OtherCSHCN
TX1393065OtherUHC PIN
TX150220509OtherCSHCN GROUP
TX111200101OtherFIRSTCARE PIN
TX127419308Medicaid
TX127419308Medicaid
TX00U87ZOtherMEDICARE GROUP
TX10029167OtherAMERIGROUP PIN