Healthcare Provider Details

I. General information

NPI: 1689272320
Provider Name (Legal Business Name): TELLO & ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 03/26/2022
Certification Date: 03/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 6TH ST STE A
LUBBOCK TX
79416-4700
US

IV. Provider business mailing address

4401 6TH ST STE A
LUBBOCK TX
79416-4700
US

V. Phone/Fax

Practice location:
  • Phone: 806-620-1767
  • Fax: 888-762-6622
Mailing address:
  • Phone: 806-928-1144
  • Fax: 888-762-6622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SARA TELLO
Title or Position: OWNER/NURSE PRACTITIONER
Credential:
Phone: 806-928-1144