Provider Demographics
NPI:1598135824
Name:TELLEZ, NELLY ELENA (APRN)
Entity Type:Individual
Prefix:
First Name:NELLY
Middle Name:ELENA
Last Name:TELLEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 ST JOSEPH PKWY STE 1309
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8236
Mailing Address - Country:US
Mailing Address - Phone:832-366-1305
Mailing Address - Fax:832-366-1287
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 1309
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8236
Practice Address - Country:US
Practice Address - Phone:832-366-1305
Practice Address - Fax:832-366-1287
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129191363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX445314YLPSOtherWELLMED MEDICARE
TX3543936-01OtherWELLMED MEDICAID