Individual
GLORIA G TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3165 COUNTY ROAD 475, NIXON, TX 78140-4013
(281) 794-6548
Mailing address
3165 COUNTY ROAD 475, NIXON, TX 78140-4013
(281) 794-6548
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
06/12/2022
Last updated
06/12/2022
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