Healthcare Provider Details

I. General information

NPI: 1902848096
Provider Name (Legal Business Name): TEJASKUMAR B PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13538 N SILVER CASSIA PL
ORO VALLEY AZ
85755-6044
US

IV. Provider business mailing address

13538 N SILVER CASSIA PL
ORO VALLEY AZ
85755-6044
US

V. Phone/Fax

Practice location:
  • Phone: 814-659-5247
  • Fax:
Mailing address:
  • Phone: 814-659-5247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number340447
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number51977
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberTPME8077
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: