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General NPI Number Information
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NPI Number | 1508960238
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Entity Type | Individual
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Provider Name | TIMOTHY ORLANDO TESI DPM
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 116 N VALE ST
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City | JEFFERSON
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State | TX
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Zip | 75657-2256
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Country | US
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Telephone | 903-665-3339
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Fax | 903-756-5748
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Provider Business Mailing Address
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Address Line | 270 E HUNT HWY STE 16 BOX 103
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143
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Country | US
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Telephone | 903-756-5540
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Fax | 903-756-5748
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 1154
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License Number State | TX
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