Provider Demographics
NPI:1285742882
Name:TEKESTE, HAGOS (MD)
Entity type:Individual
Prefix:DR
First Name:HAGOS
Middle Name:
Last Name:TEKESTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7306 SW 34TH AVE STE 1
Mailing Address - Street 2:PMB 307
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79121
Mailing Address - Country:US
Mailing Address - Phone:806-356-2260
Mailing Address - Fax:806-356-2268
Practice Address - Street 1:7306 SW 34TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-1440
Practice Address - Country:US
Practice Address - Phone:806-356-2260
Practice Address - Fax:806-356-2268
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6238174400000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100003800AMedicaid
NM000U2314Medicaid
TX00JZ71OtherALL PRIVATE INSURANCE
TX130538502Medicaid
TXB26900Medicare UPIN
NM000U2314Medicaid