Individual
MISS DIVYA JITENDRA MISTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2525 LUCAS DR, DALLAS, TX 75219-1804
(214) 528-7354
Mailing address
4401 MARTIN LUTHER KING BLVD, HOUSTON, TX 77204-2020
(713) 743-1921
(713) 743-0963
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11675TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11675TG
OPTOMETRY LICENSE
TX
Enumeration date
06/22/2026
Last updated
06/22/2026
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