Provider Demographics
NPI:1942527015
Name:TELLEZ FLORES, ISRAEL JUAN ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:ISRAEL
Middle Name:JUAN ENRIQUE
Last Name:TELLEZ FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7510 MCPHERSON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6541
Mailing Address - Country:US
Mailing Address - Phone:956-242-6790
Mailing Address - Fax:
Practice Address - Street 1:7510 MCPHERSON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6541
Practice Address - Country:US
Practice Address - Phone:956-242-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8198207P00000X
MI4301096029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine