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General NPI Number Information
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NPI Number | 1326342692
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Entity Type | Individual
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Provider Name | CANDICE MARGOT SUBAITIS D.C.
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Gender | Female
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Dates
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Enumeration Date | 12/30/2010
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Last Update Date | 10/09/2013
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Provider Practice Location Address
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Address Line | 190 E STACY RD SUITE 1614
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City | ALLEN
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State | TX
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Zip | 75002-8734
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Country | US
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Telephone | 972-678-3080
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Fax | 972-678-3083
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Provider Business Mailing Address
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Address Line | 2625 BUTTERFIELD RD STE 301N
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City | OAK BROOK
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State | IL
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Zip | 60523-1234
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Country | US
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Telephone | 630-320-6400
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Fax | 630-701-1007
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 12453
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License Number State | TX
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