| Surya Psychiatric Clinic Pllc | |
|
7410 N La Cholla Blvd Tucson AZ 85741 | |
| (520) 639-8576 | |
| (520) 639-8635 |
| Full Name | Surya Psychiatric Clinic Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7410 N La Cholla Blvd, Tucson, Arizona |
| Authorized Official Name and Position | Tejas B Patel (CEO) |
| Authorized Official Contact | 8146595247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Surya Psychiatric Clinic Pllc 7410 N La Cholla Blvd Tucson AZ 85741-2306 Ph: (520) 639-8576 | Surya Psychiatric Clinic Pllc 7410 N La Cholla Blvd Tucson AZ 85741 Ph: (520) 639-8576 |
| NPI Number | 1609385640 |
|---|---|
| Provider Enumeration Date | 09/21/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1658647375 |
|---|---|
| Medicare Enrollment ID | O20171025001623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609385640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 51977 (Arizona) | Primary |
| Provider Name | Tejaskumar B Patel |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1902848096 PECOS PAC ID: 8628081205 Enrollment ID: I20161025001788 |
| Provider Name | Gregory A Capocy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861018244 PECOS PAC ID: 1254758501 Enrollment ID: I20200901001155 |
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