Provider Demographics
NPI:1154386621
Name:GUPTA, TEJ P (MD)
Entity type:Individual
Prefix:DR
First Name:TEJ
Middle Name:P
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TEJ
Other - Middle Name:P
Other - Last Name:GUPTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1733 CURIE DR
Mailing Address - Street 2:STE 200
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2910
Mailing Address - Country:US
Mailing Address - Phone:915-534-2500
Mailing Address - Fax:915-534-0001
Practice Address - Street 1:1733 CURIE DR
Practice Address - Street 2:STE 200
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2910
Practice Address - Country:US
Practice Address - Phone:915-534-2500
Practice Address - Fax:915-534-0001
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6832207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A0045Medicare PIN
E13765Medicare UPIN