Individual
DIVYA RAJENDRA VANKAWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
10701 EAST BOULEVARD, LOUIS STOKES VAMC, CLEVELAND, OH 44106
(216) 791-3800
Mailing address
2724 VELA, GRAND PRAIRIE, TX 75054-5537
(817) 832-7719
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9322TG
TX
Other
Enumeration date
06/14/2017
Last updated
01/13/2020
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