Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | E-14422 | AR |
N | 111NI0900X | Internist | E-14422 | AR |
Y | 207RG0100X | Gastroenterologist | E-14422 | AR |
NPI | 1013681154 |
---|---|
Provider Name | Dr. Felix Ignacio Tellez Avila |
First Address | Little Rock, AR 72225-1420 |
Second Address | Little Rock, AR 72205-7101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2021 |
Last Update Date | 05/08/2021 |