MEDICARE: TEJAS BHAGAT PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	21175	NC

General Provider Information

NPI Number	:	1548562101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEJAS BHAGAT PHARM.D.

Provider Business Mailing Address
First Line	:	5408 CREEK RIDGE LN
Second Line	:	APT # O
City	:	RALEIGH
State	:	NC
Zip	:	27607-3865
Country	:	US
Telephone Number	:	919-720-0991
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 FALLS VALLEY DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-3445
Country	:	US
Telephone Number	:	919-844-5440
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2010
Last Update Date	:	12/02/2010

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