Provider Demographics
NPI:1932394483
Name:FRATTARELLI, TEASHA-LEE ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:TEASHA-LEE
Middle Name:ANN
Last Name:FRATTARELLI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:1300 W LANCASTER AVE
Practice Address - Street 2:205
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-3410
Practice Address - Country:US
Practice Address - Phone:817-336-8611
Practice Address - Fax:817-390-2981
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP45692080P0006X
OH34. 009726208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics