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1043544091
DOMINIC TELLEZ
LAS CRUCES, NM
NPI
1043544091
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NM PA2009-0029)
Enumeration Date
2009-09-23
Last Update Date
2009-09-23
Business Address
-- DOMINIC TELLEZ PA
1600 PHTORPE ROAD
LAS CRUCES, NM 88012
Phone number: 575-526-6200
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Mailing Address
-- DOMINIC TELLEZ PA
PO BOX 370
HATCH, NM 87937-0370
Phone number: 575-267-3280
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