Individual
TAYLOR REED TIDMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1233 N 18TH ST, ABILENE, TX 79601-2932
(325) 437-3687
(325) 437-1827
Mailing address
1233 N 18TH ST, ABILENE, TX 79601-2932
(325) 437-3687
(325) 437-1827
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M6917
TX
207Y00000X
Otolaryngology Physician
T2003013847
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196006401
—
TX
Enumeration date
09/11/2006
Last updated
07/13/2021
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