Provider Demographics
NPI:1285408617
Name:TELLEZ, SHADY YASDANI (DPT)
Entity type:Individual
Prefix:DR
First Name:SHADY
Middle Name:YASDANI
Last Name:TELLEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 SAN FELIPE ST STE 125
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1776
Mailing Address - Country:US
Mailing Address - Phone:713-270-5900
Mailing Address - Fax:713-270-5910
Practice Address - Street 1:7575 SAN FELIPE ST STE 125
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1776
Practice Address - Country:US
Practice Address - Phone:713-270-5900
Practice Address - Fax:713-270-5910
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist