| NPI | 1346953734 |
|---|---|
| Doing Business As | CLINICA FAMILIAR TIDWELL |
| Entity Type | Organization |
| Authorized Contact | JUDITH MICHELLE HIPOLITO Owner 832-434-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2022-12-30 |