MEDICARE: NELLY ELENA TELLEZ APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	AP129191	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	445314YLPS	OTHER	TX	WELLMED MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598135824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NELLY ELENA TELLEZ APRN

Provider Business Mailing Address
First Line	:	5815 GULF FWY STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-5362
Country	:	US
Telephone Number	:	713-643-0012
Fax Number	:	713-643-5808

Provider Business Practice Location Address
First Line	:	5815 GULF FWY STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-5362
Country	:	US
Telephone Number	:	713-643-0012
Fax Number	:	713-643-5808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2015
Last Update Date	:	07/18/2024

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Directions to “ NELLY ELENA TELLEZ APRN” Practice Location

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