| Provider / Organization | NPI | Date Certified |
|---|---|---|
| DALTON DIVAKARAN | 1689325169 | 2022-01-15 |
Dalton Divakaran is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1689325169. Registration indicates Dalton Divakaran is a provider of services with a specialization in Nursing Service Providers, Registered Nurse (Registered Nurse, ) (All Other Specialties & Provider Types, ) (Registered Nurse, Nursing Service Providers)
| Entity Type | Individual |
| Provider Name | Dalton Divakaran |
| Practice Office Address | 2509 DURANGO DR CARROLLTON, TX US |
| Practice Office Telephone | 6787776199 |
| Mailing Address | 2509 DURANGO DR CARROLLTON, TX 750105013 US |
| Business Telephone | 6787776199 |
| Code | Practice | License No State |
|---|---|---|
| 163W00000X PRIMARY | Nursing Service Providers Registered Nurse Registered Nurse All Other Specialties & Provider Types Registered Nurse Nursing Service Providers | 817979
TX |