Individual
THERESA JULIETTE TALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN CPNP-AC
Contact information
Practice address
6410 FANNIN ST STE 330, HOUSTON, TX 77030-3004
(832) 325-7288
Mailing address
835 SUGAR MAPLE FOREST ST, CROSBY, TX 77532-5633
(815) 207-0950
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
18584
TN
208000000X
Pediatrics Physician
209.019646
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
1175137
TX
Other
Enumeration date
11/20/2017
Last updated
12/12/2024
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