Provider Demographics
NPI:1922360726
Name:TELLES GARCIA, NELSON ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:ALBERTO
Last Name:TELLES GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1501 KINGS HWY
Mailing Address - Street 2:CARDIOLOGY DEPARTMENT
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103
Mailing Address - Country:US
Mailing Address - Phone:318-675-5941
Mailing Address - Fax:318-675-5686
Practice Address - Street 1:1215 PLEASANT ST STE 414
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1408
Practice Address - Country:US
Practice Address - Phone:515-241-5700
Practice Address - Fax:515-241-5780
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR9361207R00000X
LAMD.207927207R00000X
IA44968207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine