Healthcare Provider Details

I. General information

NPI: 1104320118
Provider Name (Legal Business Name): CANDYCE LEE WESTMORELAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2840 LEGACY DR STE 400
FRISCO TX
75034-6055
US

IV. Provider business mailing address

2840 LEGACY DR STE 400
FRISCO TX
75034-6055
US

V. Phone/Fax

Practice location:
  • Phone: 469-200-6100
  • Fax: 469-200-6101
Mailing address:
  • Phone: 469-200-6100
  • Fax: 469-200-6101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberT3015
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: