Provider Demographics
NPI:1932425782
Name:TEJASWI, SOORAJ (MD, MSPH)
Entity Type:Individual
Prefix:
First Name:SOORAJ
Middle Name:
Last Name:TEJASWI
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Gender:M
Credentials:MD, MSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 SELBY RANCH RD
Mailing Address - Street 2:UNIT 1
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-5822
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1411 MEDICAL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2778
Practice Address - Country:US
Practice Address - Phone:512-341-0900
Practice Address - Fax:512-341-2895
Is Sole Proprietor?:No
Enumeration Date:2010-04-18
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA111161207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology