IndividualActive
Nedra Tidwell
NPI 1790959252 · Child Intellectual and/or Developmental Disabilities Respite Care · Azle, TX
Provider details
- NPI number
- 1790959252
- Entity type
- Individual
- Primary specialty
- Child Intellectual and/or Developmental Disabilities Respite CareRespite Care Facility
- Sex
- Female
- Sole proprietor
- Yes
- License
- 28761 (TX)
Specialties & taxonomies
- Child Intellectual and/or Developmental Disabilities Respite CarePrimary385HR2060XLicense 28761 (TX)
Respite Care Facility
Nursing Service Providers
Practice location
7525 Portwood Rd
Azle, TX 76020-5835
Phone: (817) 444-5665
Fax: (817) 444-9115
Approximate (ZIP-level) locationGet directions
Mailing address
7529 Portwood Rd
Azle, TX 76020
Registry dates
- Enumerated
- 2008-04-16
- Last updated
- 2008-04-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.