MRS. NEDRA G TIDWELL (NPI# 1790959252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790959252 |
| Entity Type | Individual |
| Full Name | MRS. NEDRA G TIDWELL |
| Practice Address |
7525 Portwood Rd Azle TX 76020-5835 |
| Mailing Address |
7529 Portwood Rd Azle TX 76020 |
| Practice Telephone | 8174445665 |
| Practice Fax Number | 8174449115 |
| Mailing Telephone | 8174445665 |
| Mailing Fax Number | 8174449115 |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164X00000X | Licensed Vocational Nurse | 28761 | TX | Nursing Service Providers |
| Y | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
28761 | TX | Respite Care Facility |
| Street Address |
7525 PORTWOOD RD |
| City | AZLE |
| State | TX |
| Zip Code | 76020-5835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447537 | Azle Cube Smiles Pllc | Dentist | 100 Park Plc Ste 224, Azle, TX 76020 | 2020-11-04 |
| 1992112650 | Euverse Neuromonitoring LLC | Neurological Surgery | 1244 Boling Ranch Road N, Azle, TX 76020 | 2014-07-15 |
| 1124378351 | Kathleen C. Anderson | Speech-Language Pathologist | 15873 Flying Jib Dr., Azle, TX 76020 | 2012-09-14 |
| 1386886703 | Janie Darlene Holder | Specialist/Technologist, Other | 10934 Power Squadron Rd., Azle, TX 76020 | 2009-03-31 |
| 1245442367 | Joseph S Mccreary | Dentist | 209 Roe St, Azle, TX 76020 | 2007-05-03 |
| 1659491207 | Phyllis Ann Nelson | Dietitian, Registered | 108 Denver Trail, Harris Methodist Northwest Hospital, Azle, TX 76020 | 2007-03-29 |
| 1548386824 | Terry L Moore | Dentist | 500 Boyd Court, Colleyville, TX 76020 | 2007-03-21 |
| 1437177862 | James Lee Masson | Chiropractor | 1025 Southeast Parkway, Azle, TX 76020 | 2006-07-17 |
| 1982609269 | Azle Manor Health Care, L.l.l.p. | Skilled Nursing Facility | 721 Dunaway Ln, Azle, TX 76020 | 2005-06-14 |
| 1154801165 | Shayna Colleen Lacy | Occupational Therapist | 721 Dunaway Ln, Azle, TX 76020 | 2018-08-19 |
| Find all providers in zip 76020 | ||||
| Taxonomy Code | 385HR2060X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
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| 1164078028 | True Vine Connection, LLC | Respite Care | 4914 Inverness Ave, Fort Worth, TX 76132-1608 | 2019-08-15 |
| 1750949954 | Bristers Place, Limited Liability Company | Respite Care | 22310 Tea Rose Ct, Richmond, TX 77407-2067 | 2019-06-03 |
| 1902368111 | Sugarfruit Properties, LLC | Respite Care | 11980 Overbrook Ln Apt 907, Houston, TX 77077-6662 | 2019-04-05 |
| 1720572126 | Joyful Gyvers Adult Advancement Center | Respite Care | 2920 Motley Dr Ste 100, Mesquite, TX 75150-3456 | 2018-06-19 |
| 1013401835 | At A Better Partnership Home LLC | Respite Care | 2800 Tranquility Lake Blvd Apt 6206, Pearland, TX 77584-4682 | 2018-06-15 |
| 1255820379 | Fresh Outpouring Outreach Center | Respite Care | 186 Sandpebble Dr, The Woodlands, TX 77381-3225 | 2018-05-03 |
| 1366952061 | Jlegend Health Care Center, LLC | Respite Care | 9903 S Dairy Ashford Rd Apt 4102, Houston, TX 77099-2330 | 2017-10-07 |
| 1083139786 | Ariana Home Care LLC | Respite Care | 6226 Vicki John Dr, Houston, TX 77096-5742 | 2017-08-03 |
| Find all providers with the same taxonomy | ||||
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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.