DR. JUSTIN TIDWELL (NPI# 1639199862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639199862 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN TIDWELL |
| Credential | M.D. |
| Practice Address |
604 Indiana Lubbock TX 79415 |
| Mailing Address |
3804 53rd St Lubbock TX 79413-3824 |
| Practice Telephone | 8067759700 |
| Mailing Telephone | 8067950914 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | L5926 | TX | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245648922 | Justin Tidwell | Nurse Practitioner | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2014-07-26 |
| 1710908892 | Justin Alan Tidwell | Podiatrist | 501 N Graham St, Suite 415, Portland, OR 97227-1654 | 2006-07-22 |
| Street Address |
604 INDIANA |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831569540 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3502 9th St Ste 280, Lubbock, TX 79415 | 2015-10-07 |
| 1922447457 | Fnu Parijat Kumar | Physical Therapist | 2717 3rd Street, Aptt 803, Lubbock, TX 79415 | 2013-06-18 |
| 1851575906 | Diego Rivera, M.d., P.a. | Family Medicine | 111 University Ave, Lubbock, TX 79415 | 2007-12-26 |
| 1730206632 | Kathleen Brinkman Felts | Physical Therapist | 3710 4th Street, Lubbock, TX 79415 | 2007-03-23 |
| 1568508521 | Horace Rueben Sharp Jr. | Optometrist | 1911 4th St, Lubbock, TX 79415 | 2007-01-29 |
| 1699876201 | Patricia R. Arledge | Plastic Surgery | 3502 9th St., Suite 270, Lubbock, TX 79415 | 2006-09-26 |
| 1245330018 | Perlita Molina Sambrano-tandoc | Nurse Practitioner | 602 East Indiana Avenue, Lubbock, TX 79415 | 2006-09-22 |
| 1912944059 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3301 Clovis Road, Lubbock, TX 79415 | 2006-05-31 |
| 1497709265 | Byron Wayne Schoettle | Radiology | 602 Indiana Avenue, Lubbock, TX 79415 | 2006-05-19 |
| 1245720838 | Kelli D'ann Harris | Registered Nurse | 808 Joliet Ave Unit 220, Lubbock, TX 79415 | 2018-05-18 |
| Find all providers in zip 79415 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144648700 | Jared Walker | Emergency Medicine | 4110 17th St, Apt. 311, Lubbock, TX 79416-6042 | 2014-04-01 |
| 1629159603 | Tom R Basye | Emergency Medicine | 7905 Milwaukee Ave, Lubbock, TX 79424-0616 | 2006-10-18 |
| 1679669089 | Leslie Ralph Shauf | Emergency Medicine | 6505 2nd Street, Lubbock, TX 79416-3709 | 2006-10-04 |
| 1245252428 | Eldon Stevens Robinson | Emergency Medicine | 2602 50th St, Suite 300, Lubbock, TX 79413-4535 | 2006-07-24 |
| 1083630610 | Concord Medical Group Pllc | Emergency Medicine | 1602 Avenue Q, Lubbock, TX 79401-4732 | 2006-07-15 |
| 1053348631 | Shelton Ray Jackson | Emergency Medicine | 4407 87th St, Lubbock, TX 79424-4229 | 2006-06-27 |
| 1629014782 | Rolando N Torio | Emergency Medicine | 5811 - 11 Place, Suite 8, Lubbock, TX 79416 | 2006-06-20 |
| 1902855653 | Lhh Emergency Physicians Pllc | Emergency Medicine | 4810 N Loop 289, Lubbock, TX 79416-3025 | 2006-05-09 |
| 1962467761 | Linda Aryain Robins | Emergency Medicine | 4015 22nd Place, Lubbock, TX 79410-1121 | 2006-04-18 |
| 1619938644 | Kevin Funk | Emergency Medicine | 9306 Utica Dr, Lubbock, TX 79424-4822 | 2006-03-29 |
| Find all providers in LUBBOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.