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Contact Information

DOMINIC TELLEZ, PA
1600 PHTORPE ROAD
LAS CRUCES, NM88012
 Phone: 575-526-6200
 Fax: 575-526-2266
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for DOMINIC TELLEZ · (Male)

NPI # 1043544091
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 09/23/2009
Last updated 09/23/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • NM License # PA2009-0029
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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