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Individual

FRED E. HARDWICKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1001 US HIGHWAY 83 N, CHILDRESS, TX 79201-2322
(940) 937-3636
(940) 937-9615
Mailing address
100 BELLA VISTA ST, CHILDRESS, TX 79201-2304
(806) 778-2688
(940) 937-9615

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
H0428
TX
207RX0202X
Medical Oncology Physician
Primary
H0428
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100166970A
OK
01
114565100
FIRSTCARE COMMERCIAL
TX
05
114565101
TX
05
135619803
TX
05
135619804
TX
01
63916
PRESBYTERIAN COMMERCIAL
NM
05
63916
NM
05
77643
NM
01
81321Y
BC/BS
TX
01
84210Z
HMO BLUE
TX
01
A416
TRIWEST
Enumeration date
10/12/2005
Last updated
05/24/2021
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