Individual provider Active NPI

William Lewis Tidmore, M.D.

  • Diagnostic Radiology Physician
  • Wichita Falls, TX
National Provider Identifier
1295701241
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D6550 Issued in TX
Practice address
149 Hart St
Suite #5
Wichita Falls, TX 76311-3477
Phone
(940) 676-1886
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D6550 TX Primary

Addresses

Primary practice location

149 Hart St
Suite #5
Wichita Falls, TX 76311-3477

Mailing address

4311 Grants GLN
Wichita Falls, TX 76309-1424
Phone (940) 696-1291

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D6550TXMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295701241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 GRANTS GLN",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763091424",
            "telephone_number": "940-696-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 HART ST",
            "address_2": "SUITE #5",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763113477",
            "telephone_number": "940-676-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDMORE",
        "first_name": "WILLIAM",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "D6550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.