MEDICARE: DIANNE WADDELL SAWYER MD

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	207V00000X	Obstetrics & Gynecology Physician	G3762	TX

General Provider Information

NPI Number	:	1871583773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANNE WADDELL SAWYER MD

Provider Business Mailing Address
First Line	:	3115 PINE AVE
Second Line	:	#903
City	:	WACO
State	:	TX
Zip	:	76708-3247
Country	:	US
Telephone Number	:	254-753-5858
Fax Number	:	254-753-5883

Provider Business Practice Location Address
First Line	:	3115 PINE AVE
Second Line	:	STE 903
City	:	WACO
State	:	TX
Zip	:	76708-3247
Country	:	US
Telephone Number	:	254-753-5858
Fax Number	:	254-753-5883

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	07/08/2007

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