MEDICARE: TRISHA PATEL MD

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	207N00000X	Dermatology Physician	MD2020-1069	NM
2	207N00000X	Dermatology Physician	R7559	TX
3	207N00000X	Dermatology Physician	MTL002961	DC

General Provider Information

NPI Number	:	1053731927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRISHA PATEL MD

Provider Business Mailing Address
First Line	:	2945 RODEO PARK DR E UNIT 5
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-6312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2945 RODEO PARK DR E UNIT 5
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-6312
Country	:	US
Telephone Number	:	505-416-8484
Fax Number	:	505-702-8556

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

Provider Enumeration Date	:	04/18/2014
Last Update Date	:	02/02/2026

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Directions to “ TRISHA PATEL MD” Practice Location

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