Individual
DR. MICHELLE DENISE TEDJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8901 BOONE RD, HOUSTON, TX 77099-1659
(281) 454-0500
Mailing address
6431 FANNIN ST STE JJL 495, HOUSTON, TX 77030-1501
(713) 500-6645
(713) 500-0527
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
Q2213
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347829901
—
TX
Enumeration date
08/02/2012
Last updated
07/21/2022
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