Provider Demographics
NPI:1902981533
Name:DESAI, TEJAS D (DO)
Entity Type:Individual
Prefix:DR
First Name:TEJAS
Middle Name:D
Last Name:DESAI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2120 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2418
Mailing Address - Country:US
Mailing Address - Phone:713-864-2659
Mailing Address - Fax:713-864-5577
Practice Address - Street 1:2120 ASHLAND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2418
Practice Address - Country:US
Practice Address - Phone:713-864-2659
Practice Address - Fax:713-864-5577
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8958207N00000X
TXM6586207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery