MEDICARE: DR. SHARAFALI Y DIWAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	J6920	TX

General Provider Information

NPI Number	:	1114927290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARAFALI Y DIWAN M.D.

Provider Business Mailing Address
First Line	:	18220 TOMBALL PKWY
Second Line	:	SUITE 230
City	:	HOUSTON
State	:	TX
Zip	:	77070-4347
Country	:	US
Telephone Number	:	832-604-0005
Fax Number	:	832-604-0103

Provider Business Practice Location Address
First Line	:	18220 TOMBALL PKWY
Second Line	:	SUITE 230
City	:	HOUSTON
State	:	TX
Zip	:	77070-4347
Country	:	US
Telephone Number	:	832-604-0005
Fax Number	:	832-604-0103

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	07/08/2007

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