Healthcare Provider Details

I. General information

NPI: 1245578046
Provider Name (Legal Business Name): SIERRA JOY SANTELLANA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SIERRA JOY TESCH PA-C

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 FANNIN ST STE 262
HOUSTON TX
77002-6943
US

IV. Provider business mailing address

PO BOX 211699
EAGAN MN
55121-3699
US

V. Phone/Fax

Practice location:
  • Phone: 866-849-0692
  • Fax: 888-973-8821
Mailing address:
  • Phone: 866-849-0692
  • Fax: 888-973-8821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA08309
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: