1. Home
  2. Directory
  3. Texas
  4. Huntsville
  5. Physician Assistant
  6. NPI Profile

MRS. DYVETTE L WARREN PAC
NPI 1477872190
Physician Assistant - Medical in Huntsville, TX

Active since May 19, 2010PECOS Enrolled
179 INTERSTATE 45 S, SUITE 300, HUNTSVILLE, TX 77340(936) 294-0152(936) 294-9600 Get Directions Write a Review

NPPES record last updated: May 19, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Dyvette L Warren Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. DYVETTE L WARREN PAC (NPI 1477872190) is an individual medical provider in Huntsville, Texas, licensed in Texas (PA03155) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477872190
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. DYVETTE L WARRENCredential: PAC
Location Address179 INTERSTATE 45 S, SUITE 300Huntsville, TX 77340-4223
Mailing Address179 Interstate 45 S, Suite 300Huntsville, TX 77340-4223 · (936) 294-0152 · Fax (936) 294-9600
Phone(936) 294-0152
Fax(936) 294-9600
Sole ProprietorYes
Enumeration DateMay 19, 2010
✔ NPI 1477872190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in TX · PA03155
179 INTERSTATE 45 S, Huntsville, TX 77340
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Dyvette L Warren Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MIR MUJTABA ALI KHAN D.O.
Internal Medicine
179 INTERSTATE 45 S, SUITE 300
HUNTSVILLE, TX 77340
Walker County (936) 294-0152

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dyvette Warren's NPI number?

The NPI number for Dyvette Warren is 1477872190. It was assigned to this individual provider in the NPPES registry on May 19, 2010.

Where is Dyvette Warren located?

Dyvette Warren practices at 179 Interstate 45 S Suite 300, Huntsville, TX 77340. The listed phone number is (936) 294-0152.

What is Dyvette Warren's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Dyvette Warren enrolled in Medicare?

Yes. Dyvette Warren is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Dyvette Warren was last updated on May 19, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.