Provider Demographics
NPI:1285624684
Name:TELLEZ, FRANCISCO L (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:L
Last Name:TELLEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1802 PAPERMILL RD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1100
Mailing Address - Country:US
Mailing Address - Phone:610-372-0712
Mailing Address - Fax:610-376-6968
Practice Address - Street 1:1802 PAPERMILL RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1100
Practice Address - Country:US
Practice Address - Phone:610-372-0712
Practice Address - Fax:610-376-6968
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD061090L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4328857OtherAETNA
PA0016291400002Medicaid
PA0216286000OtherKEYSTONE HEALTH EAST
PA01904403OtherCAPITAL BLUE CROSS
PA535131OtherHIGHMARK BLUE SHIELD
PA0216286000OtherKEYSTONE HEALTH EAST
PA01904403OtherCAPITAL BLUE CROSS