Individual
MS. CECILIA MARIA TELLEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
18424 S HWY 28, SAN MIGUEL, NM 88058
(575) 233-3830
(575) 233-4542
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20020162
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
346734703
MEDICARE
NM
05
—
78659230
—
NM
Enumeration date
08/09/2006
Last updated
08/29/2018
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