Organization
PETER A BIDWELL FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER A BIDWELL MD (OWNER)
(409) 384-3421
Entity
Organization
Contact information
Practice address
1007 DICKERSON DR, JASPER, TX 75951-5110
(409) 384-3421
(409) 384-7443
Mailing address
1007 DICKERSON DR, JASPER, TX 75951-5110
(409) 384-3421
(409) 384-7443
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
FO386
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046QP
BCBS
TX
Enumeration date
04/10/2007
Last updated
03/12/2008
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