Organization
JP LETELLIER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN-PIERRE LETELLIER (CEO)
(432) 758-4960
Entity
Organization
Contact information
Practice address
1004 HOBBS HWY, SUITE 4, SEMINOLE, TX 79360-3300
(432) 758-4960
(432) 758-4979
Mailing address
1004 HOBBS HWY, SUITE 4, SEMINOLE, TX 79360-3300
(432) 758-4960
(432) 758-4979
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
M3003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0025PT
BLUE CROSS AND BLUE SHIELD
TX
01
—
141430
SUPERIOR CHIPS
TX
05
—
178909105
—
TX
01
—
178909106
MEDICAID HEALTHSTEPS
TX
Enumeration date
08/28/2007
Last updated
02/23/2016
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