Healthcare Provider Details

I. General information

NPI: 1265939979
Provider Name (Legal Business Name): DIVYA RAJU DHOOT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 E SYCAMORE ST STE 100
SHERMAN TX
75090-5017
US

IV. Provider business mailing address

PO BOX 837
HOWE TX
75459-0837
US

V. Phone/Fax

Practice location:
  • Phone: 903-202-2900
  • Fax: 903-202-2901
Mailing address:
  • Phone: 903-487-2248
  • Fax: 903-487-2306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.142015
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: