Provider Demographics
NPI:1164480794
Name:PATEL, TUSHAR RAMESCHANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:TUSHAR
Middle Name:RAMESCHANDRA
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1131 EAGLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7476
Mailing Address - Country:US
Mailing Address - Phone:915-742-3014
Mailing Address - Fax:915-742-2161
Practice Address - Street 1:BUILDING NUMBER 2487, CARRINGTON RD.
Practice Address - Street 2:
Practice Address - City:FT. BLISS
Practice Address - State:TX
Practice Address - Zip Code:79906
Practice Address - Country:US
Practice Address - Phone:915-742-3014
Practice Address - Fax:915-742-2161
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012391812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
192145OtherANTHEM HEALTH KEEPERS
192145OtherANTHEM BCBS
192145OtherANTHEM PPO BCBS
268181OtherCOMPSYCH
192145OtherANTHEM HEALTH KEEPERS
192145OtherANTHEM PPO BCBS