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General NPI Number Information
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NPI Number | 1710037023
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Entity Type | Individual
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Provider Name | CANDACE FREEMAN MCDANIEL D.O.
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8021 EAST R. L. THORNTON FRWY SUITE A
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City | DALLAS
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State | TX
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Zip | 75228
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Country | US
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Telephone | 214-328-4848
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Fax | 214-328-4819
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Provider Business Mailing Address
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Address Line | 4 WOODLAND DR
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City | MANSFIELD
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State | TX
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Zip | 76063-6086
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Country | US
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Telephone | 817-800-3188
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Fax | 214-328-4819
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | K7336
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License Number State | TX
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