Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | K7336 | TX |
NPI | 1710037023 |
---|---|
Provider Name | Dr. Candace Freeman Mcdaniel |
First Address | Mansfield, TX 76063-6086 |
Second Address | Dallas, TX 75228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 08/07/2007 |