Provider Demographics
NPI:1639311194
Name:VARU, DIVYA M (MD)
Entity Type:Individual
Prefix:DR
First Name:DIVYA
Middle Name:M
Last Name:VARU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DIVYA
Other - Middle Name:
Other - Last Name:MUTYALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:901 MOPAC EXPY S
Mailing Address - Street 2:BARTON OAKS PLAZA IV, SUITE 350
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-347-0255
Mailing Address - Fax:
Practice Address - Street 1:901 MOPAC EXPY S
Practice Address - Street 2:BARTON OAKS PLAZA IV, SUITE 350
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-347-0255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1526207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology