Mdtela

NPI #1295337723 in Streetman, Texas

Provider Information

NPI Number: 1295337723
Entity Type: Organization
Organization Name: Mdtela
Primary Specialty: Family Medicine
Enumeration Date: Nov 10, 2020
Last Updated: Nov 10, 2020

Practice Location

Address: 160 SEPTEMBER DR
City: Streetman
State: Texas
ZIP Code: 75859-3261
Phone: (833) 463-8352

Authorized Official

Name: KIMBERLY TATUM, OWNER
Title: ADMINISTRATOR
Phone: (931) 628-9210

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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