Mdtela Professional Limited

NPI #1083299101 in Streetman, Texas

Provider Information

NPI Number: 1083299101
Entity Type: Organization
Organization Name: Mdtela Professional Limited
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Mar 10, 2021
Last Updated: Mar 10, 2021

Practice Location

Address: 160 SEPTEMBER DR
City: Streetman
State: Texas
ZIP Code: 75859-3261
Phone: (931) 628-9210

Authorized Official

Name: KIMBERLY TATUM, NP
Title: OWNER
Phone: (909) 599-2852

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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