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General NPI Number Information
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NPI Number | 1316215130
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Entity Type | Organization
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Legal Business Name | EXCELL PEDIATRICS
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 8388 W SAM HOUSTON PKWY S 168
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City | HOUSTON
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State | TX
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Zip | 77072-5079
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Country | US
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Telephone | 281-974-2967
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Fax |
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Provider Business Mailing Address
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Address Line | 4114 N BRAESWOOD BLVD
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City | HOUSTON
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State | TX
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Zip | 77025-2906
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Country | US
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Telephone | 281-974-2967
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA EMILIA TELLEZ
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Credential | MD
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Telephone | 281-974-2967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | L4753
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License Number State | TX
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