Active NPI
Mary Ellen F Teletzke, RPH.
- Pharmacist
- Missouri City, TX
National Provider Identifier
1184953994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26847
- Practice address
- 4790 Lexington Blvd
Missouri City, TX 77459-2800 - Phone
- (281) 499-5257
- Fax
- (281) 499-3772
- NPI assigned
- Dec 8, 2009
- Last updated
- Dec 8, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26847 | TX | Primary |
Addresses
Primary practice location
4790 Lexington Blvd
Missouri City, TX 77459-2800
Mailing address
4790 Lexington Boulevard
Missouri, TX 77459
Phone (281) 499-5257
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26847 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260230400000",
"number": "1184953994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4790 LEXINGTON BOULEVARD",
"city": "MISSOURI",
"state": "TX",
"postal_code": "77459",
"telephone_number": "281-499-5257",
"fax_number": "281-499-3772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4790 LEXINGTON BLVD",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774592800",
"telephone_number": "281-499-5257",
"fax_number": "281-499-3772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELETZKE",
"first_name": "MARY ELLEN",
"middle_name": "F",
"credential": "RPH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-08",
"last_updated": "2009-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "26847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missouri City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.