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NPI Code Detail

MEDICARE: CANDICE NASTASSIA SCOBY

MEDICARE:   CANDICE NASTASSIA SCOBY
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
1235Z00000XSpeech-Language Pathologist106180TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1106180OTHERTXTX DEPT. OF LICENSING AND REGULATION
235077156OTHERTXTX DRIVER LICENSE

General Provider Information

NPI Number : 1275824344
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDICE NASTASSIA SCOBY
Provider Business Mailing Address
First Line : 10901 RANCHSTONE DR APT 1012
Second Line :
City : HOUSTON
State : TX
Zip : 77064-8889
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7215 WINDFERN RD
Second Line :
City : HOUSTON
State : TX
Zip : 77040-2301
Country : US
Telephone Number : 713-466-8933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2011
Last Update Date : 10/02/2018

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Directions to “ CANDICE NASTASSIA SCOBY ” Practice Location

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