Tidwell, Crockett

Tidwell, Crockett is an individual health care provider with primary practice located at 4205 98Th St , Lubbock TX 79423-3971. He recently has only one registered license in Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, which is considered as his primary health care specialty. Tidwell, Crockett can be contacted via phone (806) 798-6115.

Contact Information

Primary practice address
4205 98Th St Lubbock TX 79423-3971
Phone: (806) 798-6115
Fax: (806) 798-6117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 38448 Texas

Profile Details

NPI number 1013319714
LBN Legal business name Tidwell, Crockett
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 24th, 2014
Last updated Sep 24th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013319714 NPPES
Texas Other 38448 PHARMACY LICENSE

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