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General NPI Number Information
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NPI Number | 1750938247
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Entity Type | Individual
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Provider Name | JOEL E TELLEZ QUIROGA MD
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Gender | Male
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 5802 SARATOGA BLVD STE 200
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City | CORPUS CHRISTI
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State | TX
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Zip | 78414-4252
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Country | US
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Telephone | 361-986-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 849 KELLOGG AVE
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City | JANESVILLE
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State | WI
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Zip | 53546-2808
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Country | US
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Telephone | 608-755-7960
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Fax | 608-755-7873
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | V3121
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License Number State | TX
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