Individual
ADEN D TADELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08906
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336429108
—
TX
01
—
336429109
MEDICAID CSHCN
TX
01
—
8MK724
BCBS
TX
01
—
P02586315
RAILROAD MEDICARE
TX
Enumeration date
04/03/2014
Last updated
04/05/2022
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