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General NPI Number Information
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NPI Number | 1528728110
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Entity Type | Individual
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Provider Name | MISS DIVYA SRINIVASAN
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Gender | Female
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 7077 HIGHWAY 6 N
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City | HOUSTON
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State | TX
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Zip | 77095-2505
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Country | US
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Telephone | 713-333-7262
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Fax |
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Provider Business Mailing Address
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Address Line | 3623 W ALABAMA ST
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City | HOUSTON
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State | TX
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Zip | 77027-5927
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Country | US
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Telephone | 832-797-1739
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1186711
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License Number State | TX
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