Provider Demographics
NPI:1194052274
Name:HIDELL, NIVEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NIVEN
Middle Name:
Last Name:HIDELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7074 CHANTILLY LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-2812
Mailing Address - Country:US
Mailing Address - Phone:214-991-0047
Mailing Address - Fax:
Practice Address - Street 1:7930 BELT LINE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-8130
Practice Address - Country:US
Practice Address - Phone:972-716-0937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43658183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist