Individual
DR. WILLIAM LEWIS TIDMORE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
149 HART ST, SUITE #5, WICHITA FALLS, TX 76311-3477
(940) 676-1886
Mailing address
4311 GRANTS GLN, WICHITA FALLS, TX 76309-1424
(940) 696-1291
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D6550
TX
Other
Enumeration date
02/28/2006
Last updated
07/08/2007
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