MEDICARE: DR. NIVEN HIDELL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	43658	TX

General Provider Information

NPI Number	:	1194052274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIVEN HIDELL PHARMD

Provider Business Mailing Address
First Line	:	7074 CHANTILLY LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-2812
Country	:	US
Telephone Number	:	214-991-0047
Fax Number	:

Provider Business Practice Location Address
First Line	:	7930 BELT LINE RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-8130
Country	:	US
Telephone Number	:	972-716-0937
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2009
Last Update Date	:	11/10/2009

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Directions to “ DR. NIVEN HIDELL PHARMD” Practice Location

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