Individual
RUBEN TELLEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 W. FIR, PORTALES, NM 88130
(575) 356-5112
Mailing address
1100 W. 21ST STREET, CLOVIS, NM 88101
(575) 769-2345
(575) 769-9013
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/19/2014
Last updated
03/17/2015
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