Individual
RICHARD D IDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-7777
Mailing address
PO BOX 731912, DALLAS, TX 75373-1912
(903) 877-7777
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
Q3701
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
03/29/2010
Last updated
10/10/2016
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