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Mr. Crockett Tidwell, RPH
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Lubbock, Texas
NPI 1013319714

Crockett Tidwell is a Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist based in Lubbock, TX and is specialized in Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist. Crockett Tidwell practices in Lubbock, TX and has the professional credentials of RPH. The NPI Number for Crockett Tidwell is 1013319714 and holds a License No. 38448 (Texas).

The current practice location address for Crockett Tidwell is 4205 98Th St, Lubbock, TX and can be reached out via phone at 806-798-6115 and via fax at 806-798-6117. You can also correspond with Crockett Tidwell through the mailing address at 4205 98TH ST, LUBBOCK, TX - 79423-3971 (mailing address contact number: 806-798-6115).

Location: 4205 98Th St, Lubbock, TX, 79423-3971
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Provider Profile Details
NPI Number
1013319714
Provider Name
Crockett Tidwell
Credential
RPH
Provider Entity Type
Individual
Gender
Male
Address
4205 98Th St, Lubbock, TX, 79423-3971
Phone Number
806-798-6115
Fax Number
806-798-6117
Provider Enumeration Date
09/24/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
38448 01 TX PHARMACY LICENSE
institution
Provider Business Practice Location Address Details
Address
4205 98Th St
City
State
Zip
79423-3971
Phone Number
806-798-6115
Fax Number
806-798-6117
person
Provider Business Mailing Address Details
Address
4205 98Th St
City
State
Zip
79423-3971
Phone Number
806-798-6115
Fax Number
806-798-6117
person
Provider's Taxonomy Details 1
Type
Pharmacy Service Providers
Classification
Pharmacist
Speciality
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Taxonomy
License No.
38448 (Texas)
Definition
Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management.
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