Provider Demographics
NPI:1972786648
Name:JOSEPH M TEJAN MD PA
Entity Type:Organization
Organization Name:JOSEPH M TEJAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-283-0200
Mailing Address - Street 1:1001 YORK DRIVE
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2083
Mailing Address - Country:US
Mailing Address - Phone:972-283-0200
Mailing Address - Fax:972-283-2515
Practice Address - Street 1:1001 YORK DRIVE
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2083
Practice Address - Country:US
Practice Address - Phone:972-283-0200
Practice Address - Fax:972-283-2515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7630207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200045618OtherRAILROAD MEDICARE
TX029941402Medicaid
TX4906490001OtherCIGNA GOVERNMENT SERVICES
TX00405UOtherMEDICARE GROUP
TX00405UOtherMEDICARE GROUP
TX8A0147Medicare PIN