Healthcare Provider Details

I. General information

NPI: 1003113200
Provider Name (Legal Business Name): DISHA AWASTHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N KOBAYASHI STE 208
WEBSTER TX
77598-4841
US

IV. Provider business mailing address

PO BOX 58538
WEBSTER TX
77598-8538
US

V. Phone/Fax

Practice location:
  • Phone: 281-724-8180
  • Fax: 281-336-1171
Mailing address:
  • Phone: 346-474-1934
  • Fax: 346-472-2278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberT3584
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberT3584
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: