Telelab

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TELELAB

Practice address

6889 W Charleston Blvd Ste a
Las Vegas, NV 89117-1644

Phone

(702) 779-3582

Fax

(702) 508-2435

NPI assigned

Jul 27, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alicia Walker

Title

Owner

Phone

(702) 901-9081

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Body and Mind Health Partners Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1639788599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7881 W CHARLESTON BLVD STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891178327",
            "telephone_number": "702-508-2153",
            "fax_number": "702-508-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6889 W CHARLESTON BLVD STE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171644",
            "telephone_number": "702-779-3582",
            "fax_number": "702-508-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELELAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-901-9081"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "NV20201850927",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Body and Mind Health Partners",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dean Tan Telada
• Teladentist PC Inc
• Andrea Kathleen Telatovich, AU.D.
• Kassandra Telega, RN
• Telehealth Clinical Evals LLC
• Telemdcare
• Telemed Now, PLLC
• Telemedicine Wellness LLC
• Telemind Inc
• Telepsycrx LLC

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.