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Individual

ERIC TIDLINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3007 CAROLINE ST, HOUSTON, TX 77004-2822
(713) 528-2328
Mailing address
5631 DRAKESTONE BLVD, HOUSTON, TX 77053-2010
(713) 434-1353

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
26747
TX

Other

Enumeration date
08/20/2019
Last updated
08/20/2019
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