Gloria G Tidwell
Individual provider Active NPI Respite Care · Nixon, TX
NPI 1306576566 · NPPES record last updated Jun 12, 2022
Key facts
- NPI
- 1306576566
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Respite Care 385H00000X
- Practice address
- 3165 County Road 475
Nixon, TX 78140-4013 - Phone
- (281) 794-6548
- NPI assigned
- Jun 12, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Respite Care | 385H00000X | Yes |
Addresses
Primary practice location
3165 County Road 475
Nixon, TX 78140-4013
Mailing address
3165 County Road 475
Nixon, TX 78140-4013
Phone (281) 794-6548
Other providers in Nixon, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.