Healthcare Provider Details

I. General information

NPI: 1902729882
Provider Name (Legal Business Name): CANDICE FALCON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8915 S PECOS RD STE 17A
HENDERSON NV
89074-7150
US

IV. Provider business mailing address

5020 RENO CT
LAS VEGAS NV
89119-2243
US

V. Phone/Fax

Practice location:
  • Phone: 833-215-8218
  • Fax:
Mailing address:
  • Phone: 833-215-8218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number2013838.081-122
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: