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Individual

DAYNA GWINUP DIVEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5103 KYLE CENTER DR, SUITE 104, KYLE, TX 78640-6163
(512) 504-0855
Mailing address
1601 RIO GRANDE ST STE 340, AUSTIN, TX 78701-1162
(512) 324-8960

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
H2340
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
124705808
TX
05
124705809
TX
Enumeration date
07/10/2006
Last updated
01/31/2013
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