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NPI Code Detail

MEDICARE: CANDACE LYNN WALKLEY M.D.

MEDICARE:   CANDACE LYNN WALKLEY  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0200XInfectious Disease Physician023916LA
2207R00000XInternal Medicine PhysicianR2781TX

General Provider Information

NPI Number : 1013939560
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDACE LYNN WALKLEY M.D.
Provider Business Mailing Address
First Line : 1169 GRAND CENTRAL PKWY BLDG E
Second Line :
City : CONROE
State : TX
Zip : 77304-3185
Country : US
Telephone Number : 936-525-3600
Fax Number :
Provider Business Practice Location Address
First Line : 1169 GRAND CENTRAL PKWY BLDG E
Second Line :
City : CONROE
State : TX
Zip : 77304-3185
Country : US
Telephone Number : 936-525-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 04/04/2024

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