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General NPI Number Information
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NPI Number | 1215971072
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Entity Type | Organization
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Legal Business Name | SHARAF DIWAN, M.D., P.A. LLC
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 07/05/2011
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Provider Practice Location Address
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Address Line | 18220 TOMBALL PKWY #230
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City | HOUSTON
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State | TX
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Zip | 77070-4347
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Country | US
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Telephone | 832-604-0005
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Fax | 832-604-0103
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Provider Business Mailing Address
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Address Line | 18220 TOMBALL PKWY #230
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City | HOUSTON
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State | TX
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Zip | 77070-4347
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Country | US
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Telephone | 832-604-0005
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Fax | 832-604-0103
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Authorized Official
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Title or Position | MEMBER
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Name | DR. SHARAF Y DIWAN
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Credential | M.D.
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Telephone | 832-604-0005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | J6920
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License Number State | TX
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