Individual
DR. DIVYA SRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5939 HARRY HINES BLVD, UTSW DEPARTMENT OF DERMATOLOGY, DALLAS, TX 75235-6246
(214) 645-8947
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-2400
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301087723
MI
207ND0101X
MOHS-Micrographic Surgery Physician
N3326
TX
207NS0135X
Procedural Dermatology Physician
N3326
TX
Other
Enumeration date
05/29/2007
Last updated
07/20/2011
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