Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tidwell Pharmacy

Organization Pharmacy · NPI 1538295944

Tidwell Pharmacy is a Pharmacy in Pearland, Texas. Licensed in Texas. Registered with an NPI since 2007.

Licensed in
TX
In the registry since
2007
Specialties on file
2

Practice location Address checks out

12280 Broadway St Bldg 4 Unit 4124
Pearland, TX 77584-4352
Phone: (713) 884-8807
Fax: (713) 884-8824
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 23350 (TX)
Pharmacy Taxonomy 333600000X

Record details

NPI number1538295944
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ravishanker Mallapuram — Owner · (713) 884-8807
Other names Tidwell Pharmacy
NPI enumeratedFebruary 27, 2007
Last updated in NPPESOctober 11, 2024
Certification dateOctober 11, 2024
Mailing address12280 Broadway St Bldg 4 Unit 4124, Pearland, TX 77584-4352

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