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General NPI Number Information
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NPI Number | 1528313913
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Entity Type | Individual
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Provider Name | JADE MICHELLE TEAKELL M.D., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/21/2012
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 5656 KELLEY ST
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City | HOUSTON
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State | TX
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Zip | 77026-1967
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Country | US
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Telephone | 713-566-4550
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Fax |
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Provider Business Mailing Address
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Address Line | 6431 FANNIN STREET MSB 5.134
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 713-500-6880
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | P6734
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP10039832
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License Number State | TX
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