MEDICARE: DR. MICHELLE LYNN TEJADA AUD, CCC/A

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	231H00000X	Audiologist	DA13005	AZ
2	231H00000X	Audiologist	51008	TX
3	237600000X	Audiologist-Hearing Aid Fitter	51008	TX

General Provider Information

NPI Number	:	1720270259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE LYNN TEJADA AUD, CCC/A

Provider Business Mailing Address
First Line	:	5145 E 5TH ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-2327
Country	:	US
Telephone Number	:	520-232-7039
Fax Number	:	520-232-7002

Provider Business Practice Location Address
First Line	:	5145 E 5TH ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-2327
Country	:	US
Telephone Number	:	520-232-7039
Fax Number	:	520-232-7002

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

Provider Enumeration Date	:	08/17/2007
Last Update Date	:	10/14/2025

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