Provider Demographics
NPI:1801541602
Name:TELLEZ MONTERO, IDALMA HILDA (FNP-C)
Entity type:Individual
Prefix:
First Name:IDALMA
Middle Name:HILDA
Last Name:TELLEZ MONTERO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6220 BINZ ENGLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-1978
Mailing Address - Country:US
Mailing Address - Phone:210-612-7191
Mailing Address - Fax:210-474-0230
Practice Address - Street 1:6220 BINZ ENGLEMAN RD STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-1978
Practice Address - Country:US
Practice Address - Phone:210-612-7191
Practice Address - Fax:210-474-0230
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1002615163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse