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Individual

DR. DIVYA PIOUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
800 E DAWSON ST, TYLER, TX 75701
(903) 606-4593
Mailing address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 606-4593

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
30741
OK
207R00000X
Internal Medicine Physician
Primary
R5522
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1F7613
MEDICARE
TX
05
380649902
TX
Enumeration date
04/18/2014
Last updated
07/06/2022
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