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General NPI Number Information
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NPI Number | 1124997812
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Entity Type | Organization
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Legal Business Name | LOTUS LLC
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Dates
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Enumeration Date | 11/01/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 2945 RODEO PARK DR E UNIT 5
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City | SANTA FE
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State | NM
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Zip | 87505-6312
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Country | US
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Telephone | 505-303-0564
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Fax |
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Provider Business Mailing Address
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Address Line | 3480 TODOS SANTOS ST APT C304
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City | SANTA FE
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State | NM
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Zip | 87507-6212
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | TRISHA JAYANTILAL PATEL
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Credential |
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Telephone | 903-815-0274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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