Healthcare Provider Details

I. General information

NPI: 1508745035
Provider Name (Legal Business Name): CHIOMA CYNTHIA ANYANWU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 11/15/2025
Certification Date: 11/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3560 DELAWARE ST STE 502
BEAUMONT TX
77706-3061
US

IV. Provider business mailing address

3560 DELAWARE ST STE 502
BEAUMONT TX
77706-3061
US

V. Phone/Fax

Practice location:
  • Phone: 409-899-4472
  • Fax: 409-899-9795
Mailing address:
  • Phone: 409-899-4472
  • Fax: 409-899-9795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1180034
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: