Provider Demographics
NPI:1245612738
Name:TINDEL, FRED (RPH)
Entity Type:Individual
Prefix:MR
First Name:FRED
Middle Name:
Last Name:TINDEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 OAKMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3904
Mailing Address - Country:US
Mailing Address - Phone:817-423-9569
Mailing Address - Fax:817-423-9582
Practice Address - Street 1:7400 OAKMONT BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-3904
Practice Address - Country:US
Practice Address - Phone:817-423-9569
Practice Address - Fax:817-423-9582
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist