Provider Demographics
NPI:1215910237
Name:PATEL, TEJAL AMAR (MD)
Entity type:Individual
Prefix:DR
First Name:TEJAL
Middle Name:AMAR
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6545 MAIN STREET
Mailing Address - Street 2:OPC21
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-441-9948
Mailing Address - Fax:
Practice Address - Street 1:6545 MAIN STREET
Practice Address - Street 2:OPC21
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-441-9948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1050207RH0003X
FLME91092207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01142071OtherRR MEDICARE
TX1215910237OtherBLUE CROSS BLUE SHIELD
TXP01142071OtherRR MEDICARE