Healthcare Provider Details

I. General information

NPI: 1720935331
Provider Name (Legal Business Name): ANUSHA JIWANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4780 SWEETWATER BLVD STE 100
SUGAR LAND TX
77479-3163
US

IV. Provider business mailing address

1603 MEADOWSWEET DR
SUGAR LAND TX
77479-4082
US

V. Phone/Fax

Practice location:
  • Phone: 281-764-6600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number1005108
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: