Divya Vangipuram Wyatt, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Lubbock, Texas. Her current practice location is
3601 4th St Stop 6207, Lubbock, Texas. You can reach out to her office (for appointments etc.) via phone at
(806) 743-2929.
Divya Vangipuram Wyatt is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1679139968.
Physician's Profile
Full Name | Divya Vangipuram Wyatt |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 3601 4th St Stop 6207, Lubbock, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1679139968
- Provider Enumeration Date: 05/13/2019
- Last Update Date: 04/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 5193057156
- Enrollment ID: I20191024003017
Medical Identifiers
Medical identifiers for Divya Vangipuram Wyatt such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679139968 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | T8374 (Texas) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Divya Vangipuram Wyatt is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Divya Vangipuram Wyatt, MD 3601 4th St, Lubbock, TX 79430-0002 Ph: (806) 743-2929 | Divya Vangipuram Wyatt, MD 3601 4th St Stop 6207, Lubbock, TX 79430-6207 Ph: (806) 743-2929 |
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