Healthcare Provider Details

I. General information

NPI: 1093336646
Provider Name (Legal Business Name): SANJEEVANI TOMAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANJEEVANI KUMAR TOMAR M.D.

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date: 01/11/2022
Reactivation Date: 01/27/2022

III. Provider practice location address

2501 N ORANGE AVE STE 235
ORLANDO FL
32804-4659
US

IV. Provider business mailing address

5656 KELLEY ST
HOUSTON TX
77026-1967
US

V. Phone/Fax

Practice location:
  • Phone: 407-576-8068
  • Fax: 407-303-7323
Mailing address:
  • Phone: 713-566-5100
  • Fax: 713-566-5100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberW3319
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: